Perforated Septum: Causes, Symptoms, and Treatment Options

A perforated septum is a hole in the thin wall of cartilage and bone that separates your left and right nostrils. While not always symptomatic, a perforated septum can cause various issues, such as nosebleeds, difficulty breathing, and a blocked nose sensation. In this article, we'll explore the causes, symptoms, and treatment options for a perforated septum.

What Causes a Perforated Septum?

There are several potential causes of a perforated septum, including:

• Previous nasal surgery (about 50% of cases)

• Cautery (a treatment for nosebleeds)

• Certain diseases (lupus, some cancers, syphilis, and tuberculosis)

• Nasal trauma (breaking your nose or excessive picking)

• Infections

• Overuse of nasal drugs (over-the-counter sprays or cocaine)

Symptoms of a Perforated Septum

A perforated septum may not always cause symptoms, but when it does, they can include:

• Nosebleeds

• Difficulty breathing

• Feeling of a blocked nose

• Whistling sound while breathing

Treatment Options for a Perforated Septum

Treatment for a perforated septum depends on the size of the hole and the severity of symptoms. Non-surgical options may include:

• Ointments

• Regular saline rinses

If these treatments ease your symptoms, you'll still need regular checkups to monitor the hole, as it may grow over time. A larger hole can lead to nasal instability and cause the tip or middle of your nose to droop.

When Is Surgery Necessary?

If non-surgical treatments don't work, or if the hole is causing significant problems, your doctor may recommend surgery. The success of surgery depends on the size and location of the hole, with smaller holes generally being easier to repair.

What to Expect During and After Surgery

Septum repair surgery typically takes 1 to 3 hours and is usually an outpatient procedure. Your surgeon will use tissue from your nose or mouth to cover the hole and create flaps on each side for support. Thin splints will be placed in your nose to protect the flaps, which will remain for 1-2 weeks.

During recovery, it's essential to follow your doctor's instructions, which may include avoiding heavy lifting, not blowing your nose too hard, and rinsing with saline. Most people feel back to normal within a few weeks, with follow-up visits scheduled to monitor healing.

It's crucial to address the underlying cause of the perforated septum, such as an infection, tumor, or drug use, before considering surgery. If you experience any concerning symptoms during recovery, such as bleeding, fever, or worsening pain and swelling, contact your doctor immediately.

For more information on perforated septums and their treatment, consult the following reputable sources:

• Mayo Clinic - Nasal Septal Perforation

• National Center for Biotechnology Information - Nasal Septal Perforation Repair

• American Academy of Otolaryngology-Head and Neck Surgery - Septal Perforation