How Are Nasal Septum Perforations Treated?

How Are Nasal Septum Perforations Treated?

Nasal septum perforation or septal perforation is the appearance of an abnormal hole between the two nostrils.

Between 0.9% and 2.5% of the population have a perforation of the nasal septum, which may not cause discomfort in some cases and in others significantly affect the quality of life of the patient. Septal perforation can be due to different causes, and the most common are usually complications after nasal surgery, trauma, infections, inflammations, tumors, radiotherapy, or the inhalation of toxic substances such as cocaine. Some less frequent causes are systemic diseases that cause inflammation of the nose and paranasal sinuses, affecting the blood circulation and causing tissue loss.

Impaired quality of life

The symptoms of nasal perforations vary according to their size and location; when they are small, they are usually asymptomatic, but when they are more severe, they can lead to more severe and debilitating symptoms. Severe perforations can cause but are not limited to, nasal obstruction, recurrent bleeding, scabs, infections, pressure sensation as well as an aesthetic deformity called “saddle nose” (the weakened nasal septum sinks).

For the diagnosis of perforation of the nasal septum, it is convenient to perform nasal endoscopy and a facial computed tomography that will allow assessing the severity and the relationship with the other nasal structures. In some cases, a biopsy will also be performed in the study.

Reconstruction of the perforated nasal septum

In cases where the septal perforation affects the quality of life of the patient, the closure of the perforation and the reconstruction of the septum by surgery is considered. In this sense, they have published different techniques for septal reconstruction: unilateral or bilateral flaps by advancement or rotation, inferior turbinate flap and lateral nasal wall, nostril floor flap, and frontal flap for the closure of, particularly large defects. All septum perforation closure surgeries are done under general anesthesia, and postoperative recovery is usually quick, without complications.