Nasal Septum perforation is a defect of the nasal septum, whereby there is a hole through it which creates a path from one nostril to the other. The nasal septum is the cartilage, and bone that separates the right nostril and the left nostril.
Causes of Septum Perforation
Septum perforation can be caused by different factors including:
- Infections
- Drug use
- Trauma
- Picking the nose consistently
- Diseases such as cancer and tuberculosis
- Surgical procedures in the nose
- Cautery, which is a nose bleeding treatment
- Chemotherapy
Symptoms of Septum Perforation
A perforated septum may not present any obvious symptoms. However, when it does, the symptoms may vary from mild to severe, and from one patient to the next, and are dependent on the size of the hole in the septum which ranges from small (less than 1cm), medium (1 – 2cm), and large (larger than 2cm).
Some of the common symptoms of nasal septum perforation include:
- Runny nose
- Nosebleeds
- A foul smell in the nose
- Whistling noise from the nose when breathing
- Crusting in the nose
- Trouble breathing (feeling of an obstruction)
- Recurrent headaches
- Pain in the nose
Diagnosis of Septum Perforation
If the patient doesn’t present any obvious symptoms of septum perforation, he/she may not have need to see a specialist. However, if the symptoms are present and are interfering with the individual’s daily life, then a visit to the ENT may be warranted in order to get a definitive diagnosis.
During the diagnosis, the ENT specialist will ask for a history of the patient’s medical background which includes specific medical procedures as well as lifestyle habits, he/she will also perform a physical examination of the nose, procedures such as nasal endoscopy or rhinoscopy may also be done, and eventually a biopsy for further lab tests will be recommended if the specialist thinks the perforation is as a result of a medical condition.
Treatment of Nasal Septum Perforation
The treatment of a perforated septum is dependent on the cause. The first line of treatment will be to reduce the symptoms presented by the perforated septum. These will include:
- Using saline spray to irrigate the nose
- Recommending using a humidifier
- Applying topical ointment
Placement of Nasal Septal Button
A nasal septum button is a non-surgical option that involves the use of a prosthesis in the nose to plug the hole in the septum. The doctor can use local anesthesia to insert the button which eventually seals the septum and may reduce the symptoms. Nasal septum buttons come in different types, but those that can be removed daily for cleaning are high recommended by specialists.
Surgery
Nasal Septum Perforation surgery can be used to repair the hole. During the procedure, which can take up to 3 hours depending on the size of the hole, uses a flap which can be tissue from inside the nose, or an auto graft (tissue from a different part of the body). The procedure is usually done under general anesthesia and can be done through the nostrils or open surgery depending on the size and location of the hole.
Possible Risks of Nasal Septum Perforation
Just like any other surgical procedure, septum perforation repair comes with possible complications and risks. These include:
- Bleeding
- Reaction to anesthesia
- Infection
- Changes in nasal sensation
- Persistent or Recurrent Septal Perforation
- Scarring and poor wound healing
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