Repair of Nasal Septal Perforation

Repair of Nasal Septal Perforation

Surgery Overview

The nasal septum is the structure between the nostrils that separates the nasal passages. It's made of cartilage and thin bone. A hole (perforation) can form in the cartilage as a complication of previous nasal surgery, from cocaine use, excessive nose picking, trauma, cancer, or diseases such as tuberculosis, sarcoidosis, or syphilis. As damage reduces blood supply in the septum, the cartilage begins to die, and a hole forms.

Some perforations can cause bleeding, pain, and a whistling sound when you inhale. If dried blood or scabs build up, you could also have trouble breathing through your nose.

Many perforations don't need to be closed. Small holes may need only frequent rinsing with saltwater (saline) solutions and applying lubricating gels. You can buy these without a prescription.

Several surgical techniques may be used to close a larger perforation. A surgeon may use tissue from inside your nose or from another part of your body (autograft) to stitch into the hole. Other doctors may use tissue to create a flap to cover the hole.

Surgery for large perforations usually requires general anesthesia.

A doctor may want to try a nonsurgical technique to close the hole before suggesting surgery. In some cases, a doctor may insert septal "buttons" made of silicone or other materials that are cut to fit the hole.

What To Expect After Surgery

After surgery, you will start to rinse your nose several times a day with saline. Your doctor will teach you how to use the saline. You can expect drainage after surgery.

You may need to have your nose cleaned in the doctor's office a few times. Your nose should be healed 2 to 3 weeks after the nasal pack is removed.

Avoid blowing your nose, strenuous exercise, and bending forward for a few days. And take care not to injure your nose during exercise or other activities.

Why It Is Done

Some nasal septum perforations can cause symptoms such as bleeding and pain. Small perforations can create a whistling sound when you inhale. In cases of long-term, severe perforation, the bridge of the nose can develop a saddle-shaped deformity. Surgery can resolve these problems.

How Well It Works

Surgery to repair a nasal septum perforation is usually successful.

Success of surgery depends to some extent on the size of the perforation and also on proper postsurgery care at home. Large perforations are more difficult to close.

The repair may not be as successful in people who smoke or have diabetes as in other people, because these conditions can reduce blood supply to the septum.

Risks

Bleeding and infection can occur after any surgery. Sometimes the perforation may reopen and need another surgery.

Related Information

Credits

Current as of: December 2, 2020

Author: Healthwise Staff
Medical Review:
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Donald R. Mintz MD - Otolaryngology

Disclaimer: The information contained in this website, and its associated websites, is provided as a benefit to the local community, and the Internet community in general; it does not constitute medical advice. We try to provide quality information, but we make no claims, promises or guarantees about the accuracy, completeness, or adequacy of the information contained in or linked to this website and its associated sites. As medical advice must be tailored to the specific circumstances of each patient and healthcare is constantly changing, nothing provided herein should be used as a substitute for the advice of a competent physician. Furthermore, in providing this service, Adventist HealthCare does not condone or support all of the content covered in this site. As an Adventist health care organization, Adventist HealthCare acts in accordance with the ethical and religious directives for Adventist health care services.

Find a Doctor

Find an Adventist HealthCare affiliated doctor by calling our FREE physician referral service at 800-642-0101 or by searching our online physician directory.

View Doctors

Set Your Location

Setting your location helps us to show you nearby providers and locations based on your healthcare needs.