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Septal Perforation

What is a Septal Perforation?


Septal Perforation Facts

A septal perforation, also referred to as a perforated septum, is a “hole” in the nasal septum and is considered a very complex problem. The nasal septum is the tissue that separates the nose into two distinct sides. The nasal septum is a partition in the nasal cavity, which allows proper flow of air through the nasal passageways. If the septum is perforated, the airflow can be turbulent or obstructed causing difficulty breathing, crusting, and other symptoms. It’s important to note that the perforation is located in the cartilaginous and/or bony portion of the septum. It is not just a single-layered hole—hence the complexity of the condition. It is actually a three-layered “through and through” hole, which makes correction of the problem tricky. The perforation violates all three tissue layers, including the right and left mucoperichondrium and the intervening septal cartilage or bone.

Perforated Septum Image

This cross section of a nose shows the 3 distinct layers that must be closed to repair the perforated septum. The nasal septum is the partition that separates the nose into two sides.

Causes of Septal Perforation

A hole or perforation of your nasal septum can occur as an unwanted result of previous nasal surgery, a chemical insult to the membranes, or from a nasal fracture or other nose injury. The long term use of certain steroid or other nose sprays has even been linked to this problem. The septum and its covering layers are delicate and can be easily injured.

Common Causes

The most common causes for septal perforations to occur are listed below:

Symptoms of a Perforated Septum

When a septal perforation is present, a patient can have any number of uncomfortable and irritating symptoms that make daily life more challenging. This can be represented by one, or a combination, of the symptoms listed below that can be extremely time consuming, annoying and in some cases, so debilitating that it necessitates lifestyle changes.

Common Symptoms

Recommended Treatment

Surgical treatment, known as septal perforation repair, is indicated if symptoms are chronic and effect the patient’s quality of life. Surgery is also recommended if the patient has not responded well to nonsurgical treatments.

If a patient has a septal perforation but no symptoms, surgical repair may not be necessary. Some patients, with holes in their septum that are posteriorly located deep in the nose do not even know they have a perforation, don’t need to do anything.

But, as the perforation enlarges or if the perforation is located closer to the front of the nose, symptoms increase and become more bothersome. When the patient has not responded well to non-surgical approaches, surgery is often indicated.

Dr. Kridel believes patients do much better long-term with permanent repairs with surgery rather than constant irrigations or septal buttons, because a surgical solution is more apt to return normal nasal function and be hassle-free.

Learn more about the surgical process and Dr. Kridel’s unique approach

* All information subject to change. Images may contain models.