The nasal septum is the midline vertical partition within the nose, separating the nasal cavity into two distinct halves. This structure comprises both bone and cartilage, with the anterior portion being flexible cartilage and the posterior part consisting of bone (specifically the ethmoid bone and the vomer). The septum plays a crucial role in supporting the nose’s structure and regulating airflow. It also helps filter, warm, and humidify inhaled air. This article explores whether nasal septum cartilage can regenerate after damage.
How Cartilage Heals
Cartilage, particularly the hyaline cartilage found in the nasal septum, has a very limited capacity for self-repair. This poor healing ability stems primarily from its avascular nature, meaning it lacks a direct blood supply. Unlike most other body tissues, cartilage relies on diffusion from surrounding tissues for its sustenance.
The cells responsible for maintaining cartilage, known as chondrocytes, have a restricted ability to replicate or repair themselves. Without a robust blood supply to deliver necessary components, significant damage to cartilage typically does not result in the formation of new, original cartilage tissue. Instead, the body’s response often involves the creation of fibrous scar tissue.
This scar tissue, termed fibrocartilage, differs structurally and functionally from the original hyaline cartilage. While it can provide some structural integrity, it does not possess the same properties of durability or elasticity as healthy cartilage. Due to these inherent limitations, true regrowth of the original tissue is generally not expected after significant damage.
What Happens When Septum Cartilage is Damaged
When nasal septum cartilage is damaged, it can lead to a nasal septal perforation, which is a hole in this dividing wall. Various factors contribute to such damage, including physical trauma (e.g., a broken nose), excessive nose picking, or complications from previous nasal surgeries. Long-term use of certain nasal medications, exposure to industrial chemicals, or the misuse of substances like cocaine can also compromise the cartilage. Additionally, some infections and autoimmune diseases may lead to septal deterioration and perforation.
The development of a perforation often involves disrupted blood flow to the septum, causing the cartilage tissue to become unhealthy and form a hole. This altered structure can lead to a range of symptoms impacting nasal function. Individuals might experience changes in airflow, leading to dryness and crusting inside the nose, or recurrent nosebleeds.
A whistling sound may occur when breathing through the nose, particularly with smaller perforations, due to turbulent airflow. Nasal obstruction and a feeling of congestion are also common, as the perforation can disrupt normal laminar airflow. In some cases, severe or long-standing damage can result in a noticeable dip in the bridge of the nose, known as a saddle nose deformity.
Repairing Damaged Septum Cartilage
Given the limited natural regenerative capacity of nasal septum cartilage, significant damage often requires medical intervention. For minor issues, non-surgical approaches like frequent saline rinses and lubricating gels can help manage symptoms such as dryness and crusting. Another non-surgical option for some perforations involves inserting a septal “button,” a custom-fitted device made of silicone or other flexible materials, to cover the hole.
For more substantial damage or bothersome perforations, surgical repair is frequently considered. Procedures like septoplasty are performed to correct issues such as a deviated septum, which may involve reshaping or removing portions of the bone and cartilage to improve airflow. When a septal perforation needs closing, surgeons often utilize grafting techniques.
This involves transplanting cartilage or other tissue from one part of the patient’s body to reconstruct the damaged area. Common sources for these grafts include cartilage from the patient’s own nasal septum (if enough healthy tissue is available), ear cartilage, or rib cartilage. Fascia, a type of connective tissue, may also be used as a scaffolding material. The goals of these surgical interventions are to restore the structural integrity of the septum, close any perforations, improve breathing, and alleviate associated symptoms.