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Nasal Septum Perforation

Through-and-through defect in the nasal septum cartilage or bone.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our KBB (Kulak Burun Boğaz) department. Book Appointment →

What is Nasal Septum Perforation?

Nasal septum perforation is a full-thickness defect of the cartilaginous or bony nasal septum, creating an abnormal communication between the right and left nasal cavities. It disrupts laminar airflow, generates turbulence and may cause crusting, bleeding and whistling.

Etiology includes prior septal surgery, intranasal trauma, cocaine abuse, intranasal corticosteroid misuse, granulomatous diseases (granulomatosis with polyangiitis, sarcoidosis), syphilis and malignancy. Treatment ranges from conservative humidification to surgical closure with mucosal advancement flaps or prosthetic septal buttons.

Symptoms

Whistling sound during nasal breathing
Recurrent epistaxis from perforation edges
Persistent nasal crusting and obstruction
Nasal pain and pressure sensation
Foul-smelling nasal discharge
Saddle nose deformity in large perforations
Hyposmia or anosmia

Risk Factors

Previous septoplasty or nasal surgery
Cocaine and recreational nasal drug use
Excessive intranasal corticosteroid spray use
Granulomatosis with polyangiitis
Sarcoidosis and other granulomatous diseases
Syphilis or tuberculosis
Chronic digital trauma or nose picking

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent whistling on breathing
  • Recurrent unilateral epistaxis
  • Chronic nasal crusting unresponsive to saline
  • Suspected systemic granulomatous disease
  • Progressive saddle nose deformity
  • New-onset anosmia

Treatment Methods

01
Saline irrigation and emollient ointments to maintain moisture
02
Avoidance of intranasal trauma and irritants
03
Investigation and treatment of underlying systemic disease
04
Discontinuation of cocaine or offending intranasal drugs
05
Septal button (silicone prosthesis) for symptomatic non-operative cases
06
Surgical closure with bilateral mucosal advancement flaps for small to medium defects
07
Interposition grafts (cartilage, fascia, acellular dermis)
08
Free flap reconstruction for large defects
09
Long-term humidification and ENT follow-up

Which Department to Visit?

You can visit our KBB (Kulak Burun Boğaz) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About KBB (Kulak Burun Boğaz) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.