NASAL SEPTAL PERFORATION
WHAT IS NASAL SEPTUM?
The nasal septum is a critical structure in the nose, acting as the central partition that divides the two nasal cavities.
WHAT IS NASAL SEPTAL PERFORATION?
Nasal septal perforation refers to an abnormal hole or gap in the septum. This condition can occur due to various reasons such as:
TRAUMA
Excessive nose picking leading to repeated ulceration of the nasal septum mucosa.
DRUG ABUSE
Substances like cocaine can erode the mucosal lining and eventually the septal cartilage, leading to a perforation.
NASAL SPRAYS
Overuse of over-the-counter decongestant nasal sprays can dry out and damage the nasal tissues.
INFECTIONS
Chronic infections like Leprosy, especially those untreated, can result in the degradation of the septal tissue.
AUTOIMMUNE DISEASES
Conditions like Wegener’s granulomatosis or lupus can lead to septal perforations as they may cause tissue damage
TUMOURS
Benign or malignant tumours may cause destruction of the septal tissue.
SURGICAL PROCEDURES
Rhinoplasty or septoplasty can sometimes inadvertently result in a septal perforation if not performed carefully.
SYMPTOMS
NOSEBLEEDS
Frequent, unexplained nosebleeds can be a sign.
CRUSTING
Dryness and crusting around the nostrils are common symptoms. This may lead to nasal blockage.
WHISTLING SOUND
A whistling sound from the nose or general discomfort may occur in some patients when breathing, especially during exertion.
NASAL DISCHARGE
Some people experience a foul-smelling discharge from the nose.
CHANGE IN NASAL SHAPE
Large perforations may lead to a loss of support to the nasal dorsum leading to saddle nose deformity, inverted V deformity, decreased tip projection and in extreme cases a severely shortened and contracted nose.
TREATMENT OPTIONS
CONSERVATIVE MANAGEMENT
- Saline Sprays: Helps to keep the area moist and free of crusts.
- Humidifiers: To prevent the nasal passages from drying out.
- Corticosteroid creams may help in reducing inflammation.
- Antibiotic ointments can prevent secondary infections.
- Septal Buttons: These are less invasive and can be good short-term solution to reduce symptoms.
SURGICAL CLOSURE
Surgery for nasal septal perforation is usually considered a last-resort treatment when other conservative methods have failed to provide relief or when the perforation is large and causing significant symptoms.
Dr Sandeep’s preferred method for closure of septal perforations is raising a nasal lining flap around the perforation on both the sides and placing a tissue or cartilage graft between the two mucosal layers.
Read more about the procedure that Dr Sandeep follows to diagnose and treat septal perforations