Nose
Septal Perforation Repair
A septal perforation is an opening in the wall that separates the two nasal passages. It can disturb airflow and contribute to dryness, crusting or bleeding. Treatment depends on the symptoms, the condition of the surrounding tissue and the cause of the opening. Not every perforation requires surgery.
What Symptoms Can It Cause?
Some perforations cause little or no discomfort. Others may lead to:
- Repeated crusting and dryness.
- Recurrent nosebleeds.
- A whistling sound during breathing.
- Nasal irritation or discomfort.
- A sensation of blockage despite an open nasal passage.
The size and location of the opening influence symptoms. A small perforation near the front of the nose can still be troublesome.
What Causes a Septal Perforation?
Possible causes include previous nasal surgery, trauma and repeated damage to the nasal lining. Intranasal drug use and certain inflammatory or autoimmune conditions can also damage septal tissue.
Sometimes the cause is unclear. Identifying ongoing irritation or underlying disease is important before considering repair, because these factors may affect healing.
How Is It Assessed?
An ENT assessment examines the opening’s size and location, the health of the nasal lining and the remaining support of the nose. Nasal endoscopy may help provide a more detailed view.
Your clinician will review previous procedures, injuries, nasal products and associated symptoms. Blood tests or a tissue sample may be considered when the cause is uncertain or the tissue looks abnormal. These investigations are not necessary for everyone.
Non-Surgical Treatment
Initial treatment often aims to reduce symptoms. Saline nasal products, appropriate moisturising gels and humidification may help with dryness and crusting. Avoid picking crusts or repeatedly touching the area.
A silicone septal button may be suitable for selected patients. It covers the opening without closing it with living tissue. Comfort and effectiveness vary, and ongoing care may be needed.
When Is Surgical Repair Considered?
Repair may be considered when symptoms remain troublesome despite non-surgical care and the tissue is suitable for reconstruction.
The decision depends on the opening’s dimensions, available tissue, previous surgery and underlying cause. Smoking, ongoing intranasal drug use or active inflammatory disease can impair healing and may make surgery unsuitable.
How Is the Repair Performed?
Surgery generally uses tissue flaps from within the nose, sometimes supported by a graft, to reconstruct the opening. The approach is tailored to the defect; there is no single technique appropriate for every patient.
The aim is to close the perforation and improve symptoms. Risks include bleeding, infection, scarring and incomplete closure or reopening. Some symptoms may persist even after a successful closure.
Recovery and Follow-Up
Internal splints may be used to protect the repair. Follow the surgeon’s instructions about nasal care, nose blowing, exercise and splint removal.
Regular follow-up allows healing to be checked. Recovery and the likelihood of lasting closure vary, particularly with larger defects or previously damaged tissue. Further treatment may sometimes be needed.
Discuss Your Symptoms
Contact the clinic to arrange an assessment of persistent nasal crusting, whistling or bleeding and discuss whether symptom management or repair may be appropriate.
This information provides general guidance and does not replace an individual medical assessment.
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