The nose is divided into two cavities separated by a wall of bone and cartilage called the nasal septum. Normally, the septum helps with airflow in the nasal passageways, but sometimes the septum can be damaged, which can lead to complications. A perforated septum is an injury to the septum in the form of a hole. Depending on the size of the perforation, symptoms can vary, but they usually include difficulty breathing, wheezing, pain, and more. Fortunately, perforated septa are treatable.
Perforated Septum Causes and Symptoms
A nasal septal perforation, or a hole in the septum, can be the result of a number of different injuries. Potential causes of a septal perforation include:
· Certain infections
· Trauma to the nose, such as nose fractures
· Previous nasal surgery
· Inhaled drugs such as cocaine or certain sprays
Depending on the size of the hole in the septum, you might experience many different symptoms—or even no symptoms at all. Some of the most common symptoms of a perforated septum include:
· Nasal congestion
· Runny nose
· Nasal pain
· Feeling of obstruction in the nose
· Crusting or scabbing in the nose
· Whistling while breathing through the nose
Perforated Septum Treatments
If you experience any of the symptoms listed above, talk to your doctor for a diagnosis. Your doctor will ask about your medical history and habits, such as previous surgeries, medications, and drug use, and will do an examination of your nose. Your doctor might take a biopsy if a perforation is detected.
Depending on the underlying cause of the septal perforation, your treatment plan may vary. For nonsurgical management, your doctor might recommend a nasal hygiene regimen including the use of a saline spray or rinse, antibiotics, and a humidifier. If you suffer from a chronic disease or are not otherwise a good candidate for surgery, an obturator may be placed to block the hole. This is done under local anesthesia right in the office.
In some cases of septal perforation, surgery to restore normal form and function of the septum may be recommended. This is an advanced and complicated surgery that only a few very specialized doctors can perform. Your surgeon will cut your nose on the underside and move tissue to fill in the septal hole. It is always best to replace tissue with similar tissue, but sometimes, if there is not enough healthy nasal tissue, your doctor might recruit tissue from outside the nose. Depending on the size of the perforation, your surgeon’s approach will vary. Patients can usually expect an overnight hospital stay with this kind of procedure. It may take several weeks to recover from surgery, and you may have splints in your nose for a few weeks afterward.
If you suffer from nasal obstruction, whistling in the nose, wheezing, or other persistent nasal symptoms, talk to your doctor. Your doctor can diagnose your condition and help you find the best treatment for your symptoms and ensure your nose keeps functioning at its best.