Septal Perforation Repair

Septal perforation repair is a surgical procedure to mend a tear or hole in the nasal septum, the wall of cartilage and bone that separates the two nostrils. The septum helps to support the mucous membranes of the nose and to regulate nasal air flow. While in some cases the perforation may not require surgical repair but only applications of saline solution and lubricating gels, nasal septal perforations may have serious medical consequences.

Cause of Septal Perforation

While a septal perforation may occasionally be congenital, it usually results from an injury or as a result of a disease process. A hole may develop in the septum as a result of:

  • Nasal surgery
  • Trauma
  • Drug abuse of inhaled substances, such as cocaine
  • Piercing of the septum
  • Cancer
  • Excessive nose picking
  • Disease such as syphilis, tuberculosis, and sarcoidosis.

Symptoms of Nasal Septal perforation

While small perforations of the nasal septum may go unnoticed, when damage to the septum is more severe symptoms may become more pronounced. These symptoms may include nasal bleeding, pain, and a whistling sound upon inhalation. Dried blood or scabs may also accumulate in the area and lead to difficulty in breathing through the nose. Even though some patients may not experience any symptoms from this condition, once a nasal septal perforation is detected, it should always be medically evaluated since untreated larger perforations may affect the structure of the nose and lead to physical deformities.

Septal Perforation Repair Procedure

During septal perforation repair surgery, the doctor may take a tissue graft from the inside of the nose or from another part of the body to fill in the septal hole. A tissue flap may also be created to repair the perforation. This procedure is performed under general anesthesia and can often utilize minimally invasive techniques to reduce the trauma and recovery time associated with surgery.

Larger perforations may be difficult to close. In such cases a septal perforation may be repaired with a piece of silicone plastic, sometimes referred to as a button, which is snapped together to cover the two sides of the opening. it is possible, however, for the perforation to enlarge over time, or for the plastic insert to fall off. In these situations additional treatment will be required.

Recovery from Septal Perforation Repair

After septal perforation repair, the doctor will pack the nose with a splint for 5 to 7 days. After the packing is removed, nasal drainage is likely to occur. The patient is advised to rinse the nose frequently with a saline solution to assist in the healing process. Patients can usually return to work shortly after surgery, but should avoid blowing the nose, bending forward, or exercising strenuously a few days. Full healing usually takes 2 to 3 weeks.

Risks of Septal Perforation Repair

As with any type of surgical procedure, there is a risk of infection or bleeding after the septal perforation repair. More serious complications may include severe pain, fever, pus, persistent headache or heavy bleeding. In some cases, the perforation may reopen and require additional surgery. For the majority of patients, however, a septal perforation repair is successful and results in no complications nor any need for additional treatment.

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