A nasal septum perforation refers to a hole in the septum, the wall that divides the two nasal passages. This central structure within the nose is composed of cartilage and bone, covered by a thin mucous membrane. The presence of a perforation can disrupt normal nasal function and lead to various discomforts.
Understanding Nasal Septum Perforations
The nasal septum serves as a crucial divider, ensuring separate airflow and providing structural support. When a perforation develops, this separation is compromised, affecting how air moves. The size and location of the hole can vary significantly, influencing the severity of experienced issues.
Perforations commonly arise from previous nasal surgeries, particularly those involving the septum. Chronic nose picking can also contribute by repeatedly damaging the delicate nasal lining. Certain medical conditions and prolonged use of specific nasal sprays have been associated with septum perforations.
Individuals with a perforated septum often experience symptoms such as crusts around the hole, frequent nosebleeds, or a whistling sound when breathing. Some may also report difficulty breathing or a persistent feeling of dryness within the nasal cavity.
Non-Surgical Approaches
Non-surgical methods often begin by improving nasal comfort and function. Maintaining good nasal hygiene is a primary step, involving regular saline rinses to keep nasal passages moist. Using a humidifier, especially in dry environments, can further help reduce crusting and irritation.
Applying emollients, such as petroleum jelly, inside the nose can prevent drying and minimize bleeding. These measures alleviate symptoms, particularly for smaller perforations or for individuals preferring a less invasive approach.
Another non-surgical option is a nasal septal button, a custom-made silicone device designed to cover the perforation. This prosthesis acts as a physical barrier, reducing airflow disturbances and preventing crusting. While effective for symptom relief, septal buttons are not a permanent solution and require regular cleaning.
Surgical Repair Options
Surgical intervention directly closes a nasal septum perforation, restoring the integrity of the nasal wall. The general principle involves using surrounding healthy tissue, called local flaps, to cover the hole. These flaps are carefully lifted and rotated from the adjacent nasal lining to bridge the gap.
For larger perforations or those requiring additional structural support, surgeons often employ interposition grafts. These grafts, typically made from the patient’s own cartilage, fascia, or perichondrium, are placed between the mucosal flaps. Cartilage can be harvested from the remaining septum, the ear, or even a rib, providing a rigid framework.
Fascia, a type of connective tissue, is often taken from the temple area, while perichondrium covers cartilage. These graft materials provide a scaffold for new tissue growth and help prevent recurrence. A combination of local flaps and interposition grafts is frequently utilized, especially for more complex cases.
These procedures are typically performed under general anesthesia. Surgical success is influenced by factors including perforation size and the patient’s overall health. Adherence to post-operative care instructions is important for achieving a favorable outcome.
What to Expect After Repair
Following surgical repair, patients can anticipate a period of recovery during which the nasal tissues heal. It is common to experience some mild discomfort, swelling, and bruising around the nose and eyes. Nasal packing, if used, is typically removed within a few days to a week.
Nasal splints, which provide internal support to the healing septum, are generally kept in place for about two to three weeks. Patients are usually advised to avoid strenuous activities and anything that might put pressure on the nose for several weeks. Returning to normal daily routines can vary, but many individuals resume light activities within a week or two.
Post-operative care is important for successful healing and includes regular saline rinses to keep nasal passages moist. Patients are also advised to avoid blowing their nose forcefully to prevent disrupting delicate healing tissues. Careful adherence to these guidelines helps promote proper recovery.
While surgical repair is often successful, potential complications can occur. These might include infection, bleeding, or, in some instances, the recurrence of the perforation. Regular follow-up appointments with the surgeon are important to monitor healing and address any concerns.