The nasal septum, the structure made of bone and cartilage that divides your nose into two separate chambers, is essential for proper airflow and nasal function. When a hole develops in this septum, it’s known as a perforated septum. While some perforations may go unnoticed, others can cause a range of symptoms that impact breathing, comfort, and overall quality of life. Understanding the causes, symptoms, and treatment options for a perforated septum is crucial for effectively managing this condition.
What is the Nasal Septum and Why is it Important?
The nasal septum acts as a wall running down the center of your nose, separating the left and right nostrils. It’s composed of cartilage in the front and bone further back, covered with a mucous membrane. This structure helps to regulate airflow, support the nasal structure, and maintain nasal humidity. The septum plays a vital role in ensuring that air is properly humidified and filtered as it enters the lungs.
What Causes a Septal Perforation?
A hole can develop in the nasal septum due to a variety of factors that damage the tissue. Complications from previous nasal surgeries, such as septoplasty or rhinoplasty, can sometimes lead to a perforation. Trauma to the nose, like a fractured nose or blunt force trauma, can also damage the septum and create a hole. Intranasal medication use, particularly overuse or misuse of certain nasal sprays, can damage the nasal lining over time. Cocaine use is a well-known cause of septal damage due to its severe effects on nasal tissues. Autoimmune disorders, infections, and chemical exposure are other potential causes. Even chronic nose picking can erode the septum over time. If a perforation become large the external nose shape can change leading to a saddle nose deformity.
What are the Symptoms of a Perforated Septum?
The symptoms experienced with a perforated septum vary depending on the size and location of the hole. In many cases, small perforations (less than 1 centimeter) may not cause any noticeable symptoms. Larger perforations, however, are more likely to produce symptoms such as a whistling sound when breathing through the nose, nasal crusting and scabbing, nasal obstruction, frequent nosebleeds, runny nose, nasal pain, and headaches. Some individuals may also experience a foul odor emanating from the nose, often caused by bacterial colonization and crusting.
Diagnosis of a Perforated Septum
If you suspect you have a perforated septum, it’s essential to seek medical evaluation. A doctor will typically start by reviewing your medical history and symptoms, asking about past nasal surgeries, medication use, and habits like drug use. They will then perform a physical examination of the outside of your nose for any visible deformities. A nasal examination using specialized instruments, such as a rhinoscope or nasal endoscope, will be used to visualize the inside of your nose and assess the size, location, and characteristics of the perforation. Palpation (feeling) of the septum may also be performed. In some cases, a small tissue sample (biopsy) may be taken from the edge of the perforation to rule out other underlying conditions. Laboratory tests may be ordered if a medical cause is suspected.
Prevention of Perforated Septum
While not all cases of perforated septum can be prevented, there are steps you can take to reduce your risk. Avoiding cocaine use is crucial, as it is a major risk factor for septal perforation. Use nasal sprays as directed and avoid overuse of decongestant nasal sprays. Practicing good nasal hygiene, such as avoiding excessive nose picking, is important. If you work with industrial chemicals, use appropriate protective equipment and follow safety guidelines. Treating underlying medical conditions promptly can also help prevent septal damage.
Surgery to Close/repair a septal perforation
Our experience and Dr Faris’ technique leads to successful closure of a septal perforation in over 95% of surgical cases below 3 cm in size.
Schedule a Consultation
A perforated septum can be a challenging condition, but with proper diagnosis and management, you can find relief from your symptoms and improve your quality of life. It’s important to work closely with your doctor to determine the best treatment plan for your individual needs. At Nose Reconstruction Clinic, we offer expert diagnosis and treatment solutions tailored to your individual needs. Call +31 (0) 85 029 0829 for an appointment.