The nasal septum, the wall of separation between the two nasal cavities, can contribute to nasal problems that cause breathing issues and other symptoms. Sometimes, for a variety of reasons, the septum can become perforated, meaning that a hole forms in the mucosal and cartilage part of the septum. Known as septal perforation, this condition can disrupt proper airflow, cause a whistling noise when breathing, and result in bleeding or crusting inside the nose.
The nasal septum is made of cartilage in the front and bone in the back of the nose, and is covered with protective mucosa on both sides. If that mucosa is disturbed or injured, this can lead to the development of a hole in the septum. While very small perforations may not cause many symptoms, larger holes can cause uncomfortable symptoms and can lead to compromise of the structure and support of the nose as a whole.
Septal perforation is not to be confused with a deviated septum, where the septum is crooked or off-center. This condition can also cause respiratory symptoms, but it is a distinct condition and requires different treatment.
There are multiple possible causes of septal perforation. Determining the cause is important in deciding the best route to take for treatment and ensuring that the perforation does not recur, so it's crucial to share your full medical history with your provider.
The causes of septal perforation could include:
Methods for diagnosing septal perforation may vary between individuals depending on symptoms as well as the size and location of perforation. An in-office examination might be performed to view the perforation. Your provider will need to discuss your health history in detail and review any symptoms you might be experiencing that are possibly related.
The most common symptoms include whistling or airflow noise when breathing, nasal congestion, difficulty breathing, crusting, and frequent nosebleeds. Other possible symptoms to look for are nasal pain or discomfort, an altered sense of smell, or even a visible cosmetic nasal deformity in severe cases. Symptoms will vary from patient to patient and often depend on the severity or size of the perforation and where exactly it's located on the septum.
Living with nasal problems can be extremely detrimental to quality of life. Not being able to breathe properly can affect sleep, exercise, and overall health. Treating septal perforation can help patients get back to their daily lives without ongoing discomfort and difficulty breathing. Depending on the specific situation and needs of the patient, there are a few different approaches to treating this condition.
In general, all perforations should be repaired. However, prior to surgical management, often we focus on nasal hydration to prevent enlargement of the perforation. This can include saline rinses, ointments, and humidification to reduce crusting and other symptoms and prevent enlargement of the perforation. Patients will be advised to avoid irritants, including nasal sprays, to prevent perforation from worsening. In very rare instances, when a patient is unable to undergo anesthesia or is not medically appropriate for surgery, a septal button can be placed to alleviate symptoms.
Most stable septal perforations should be repaired. Surgical techniques for septal perforation include cartilage or fascia grafting, biologic grafts, or local tissue flaps, where another part of the internal nasal structure is carefully shifted to cover the hole while still preserving the integrity of the donor area.
For any of these treatments, it is crucial to choose a facial plastic surgeon with experience in both functional and aesthetic nasal surgery. Septal perforation repair is a tedious operation with a higher than usual failure rate. Choosing a surgeon who is experienced in the nuances of this surgery and recovery is paramount to a successful repair. Dr. Melancon has spent dedicated time learning highly successful techniques of septal perforation repair during her fellowship. To learn more about fixing your septal perforation, contact Audubon Facial Plastic Surgery and make your appointment with New Orleans facial plastic surgeon Dr. Claire Melancon today.
At Audubon Facial Plastic Surgery, we know one of the most challenging parts of this process is the first step. We are a welcoming, restful place for you to come and learn about all the ways you can live life to the fullest and be the most beautiful you. Call or click to schedule a consultation to learn how you can breathe easy at Audubon Facial Plastic Surgery.
Audubon Facial Plastic Surgery
6001 Magazine Street, Ste D, New Orleans LA 70118
Audubon Facial Plastic Surgery - Northshore Location 1090 W. Causeway Approach, Mandeville LA 70471
