Septal Perforation or (hole in the septum)

Septal perforations can occur from:

• Previous septal surgery
• Vasculitic diseases
• Manual nose picking
• Cocaine use
• 50% are idiopathic – or unknown cause

These perforations can cause little or significant functional symptoms for the patient

Small perforations can whistle when the patients breathes through their nose. Large perforations do not tend to whistling they however cause a feeling of being blocked and nasal crusting which can be very troublesome for the patient. Correction of septal perforations is graded depending on the size of the perforation.

Typically small perforations are correctable with one-stage 2 hour day case procedure with high success rates > 90%.

Diagram shows the inner lining of the nose rotated on both sides of the septum to close the hole and a cartilage graft placed to repair the hole in the framework

Smaller to moderate perforations up to 3 cm can be repaired using flaps from inside the nose and cartilage grafts from your ear cartilage (see our groups publications on septal perforation). Very large perforations greater than 3-4 cm can still be surgically closed/repaired.

There are various grading systems to saddle nose deformity. However the majority can be corrected in a one-stage procedure as a day case patient. Some more severe forms will require more than one stage to successfully reconstruct the portion of the nose. We have additional techniques to repair large septal perforations not amenable to closure/repair by standard techniques.

Technique used to close all but the very largest of septal perforation.