Septal Perforation

A septal perforation is a medical condition where a “hole” exists in the nasal septum. The nasal septum is the solid cartilage wall that separates the inside of your nose into two distinct sides or nostrils. When that wall has a hole or perforation in it, the normal nasal air flow is disrupted and nasal bleeding, crusting and a feeling of breathing obstruction can occur, the hole can get larger, and the external nose can collapse.

Septal perforation repair is the procedure to temporarily or permanently close the hole in the nasal septum. The hole in a perforated septum is actually a hole in three layers, because the cartilage in the septum is covered on each side by a tissue layer of mucosa. Because of this, the repair has to be of each of these 3 layers.

Since a septal perforation is a three-layered hole, all three tissue layers will be addressed and reconstructed separately during surgery.

Several surgical techniques may be used to close a large perforation. Tissue may be used from inside your nose or from another part of your body (autograft) to stitch into the hole, or it may be used to create a flap to cover the hole.

A successful septal perforation repair is based on the closure of the perforation and restoration of the nasal septum function.

After your septal perforation surgery, you will start to rinse your nose several times a day with saline. You can expect drainage after surgery. You may need to have your nose cleaned in the doctor’s office a few times.

Healing should take about 2 to 3 weeks after the nasal pack is removed. Blowing your nose, strenuous exercise, and bending forward should be avoided for a few days.

Individuals that have symptoms such as crusting, bleeding, whistling sound (small perforation), nasal obstruction and/or nasal drainage (larger perforation), pain, or saddle nose deformity are good candidates for septal perforation.