Nasal septal perforation

Specialty of Otolaryngology / ENT

What is a perforated nasal septum?

The nose has two cavities which are separated by a septum. This is made from both bone and cartilage and is responsible for separating the nasal cavities and channelling airflow into the nose. A perforated septum described when a hole develops in the septum, which depending on the size of the hole can cause mild to extreme symptoms.

Outlook of a perforated nasal septum:

Some people with a perforated nasal septum won’t experience any symptoms, however, more severe perforations can result in more severe and debilitating symptoms. With the right treatment, a perforated septum can be fixed.

Symptoms of nasal septum perforation:

The main feature of a perforated nasal septum is a hole in the septum which can vary in size (less than 1cm to more than 2cm). Sometimes you might not be aware of a perforated nasal septum, especially if you haven’t experienced any symptoms.

Symptoms can include:

  • Nose pain
  • Headache
  • Nosebleeds
  • Wheezing when breathing through the nose
  • Feeling like the nose is blocked or obstructed
  • Scabbing in the nose

Medical tests to diagnose a perforated nasal septum:

If you suspect you may have a perforated nasal symptom, you should visit your doctor. They will examine your nose and ask for a medical history. Certain tests to better examine the perforation include a nasal endoscopy or a rhinoscopy.

What causes a perforated nasal septum?

There are numerous potential causes of a perforated nasal septum, including:

  • Prior surgery to the nose
  • Infection
  • Trauma or injury
  • Certain medicinal sprays
  • Drug use (e.g. cocaine)
  • Industrial chemical exposure

Can a perforated nasal septum be prevented?

You can reduce your risk of getting a perforated nasal septum by:

  • Using protective equipment if you work in an industry with exposure to chemicals.
  • Avoiding cocaine use
  • Avoiding nose picking

Treatments for a perforated nasal septum:

Treatment will first attempt to treat the underlying cause. There are several non-surgical measures that will also be used, including antibiotic cream, irrigating the nose with saline spray and using a dehumidifier at home. Your doctor may also recommend a prosthesis to block the hole in the septum. These can help to reduce the symptoms. In some cases, surgery will be needed to repair the hole. This is fairly complex and will be performed under general anaesthesia as tissue may be taken from your ears or ribs to fill the hole.

Which type of specialist treats a perforated nasal septum?

An otolaryngologist (ENT) surgeon would treat a perforated nasal septum.

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