Home > Health Resources > Repair of Nasal Septal Perforation
View Additional Section Content
The nasal septum is the structure between the nostrils that separates the nasal passages. The septum, composed of cartilage and thin bone, can develop a hole (perforation) in the cartilage as a complication of previous nasal surgery, from cocaine use, excessive nose picking, trauma, cancer, or diseases such as tuberculosis, sarcoidosis, or syphilis. As damage reduces blood supply in the septum, the cartilage begins to die, and a hole develops.
Some perforations can cause bleeding, pain, and a whistling sound when inhaling. If dried blood or scabs build up, you could also have trouble breathing through your nose.
Many perforations do not need to be closed. Small perforations may need only frequent rinsing with saltwater (saline) solutions and applying lubricating gels. Both can be bought without a prescription.
Several surgical techniques may be used to close a larger perforation. A surgeon may use tissue from inside your nose or from another part of your body (autograft) to stitch into the hole. Other doctors may use tissue to create a flap to cover the perforation.
Surgery for large perforations usually requires general anesthesia.
You will begin rinsing the nose several times a day with saline. Your doctor will instruct you on how to use the saline. You can expect drainage after surgery.
You may need to have your nose cleaned in the doctor's office a few times. Your nose should be healed 2 to 3 weeks after the nasal pack is removed.
Avoid blowing your nose, strenuous exercise, and bending forward for a few days. Also take care not to injure your nose during exercise or other activities.
Some nasal septal perforations can cause symptoms such as bleeding and pain. Small perforations can create a whistling sound when you inhale. In cases of long-term, severe perforation, the bridge of the nose can develop a saddle-shaped deformity. Surgery can resolve these problems.
Surgery to repair a nasal septal perforation is usually successful. But some large perforations may be hard to close.
Bleeding and infection can occur after any surgery. You should contact your doctor if you have:
Sometimes the perforation may reopen and need another surgery.
Success of surgery depends to some extent on the size of the perforation and also on proper postsurgery care at home. Large perforations are more difficult to close.
The repair may not be as successful in people who smoke or have diabetes as in other people, because these conditions can reduce blood supply to the septum.
A doctor may want to try a nonsurgical technique to close the perforation before suggesting surgery. In some cases, a doctor may insert septal "buttons" made of silicone or other materials that are cut to fit the perforation.
Other Works Consulted
Lund VJ (2009). Acute and chronic nasal disorders. In JB Snow Jr, PA Wackym, eds., Ballenger's Otorhinolaryngology: Head and Neck Surgery, 17th ed., pp. 557–566. Hamilton, ON: BC Decker.
Current as ofMarch 27, 2018
Author: Healthwise StaffMedical Review: Adam Husney, MD - Family MedicineKathleen Romito, MD - Family MedicineDonald R. Mintz, MD, FRCSC - Otolaryngology
Current as of:
March 27, 2018
Medical Review:Adam Husney, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Donald R. Mintz, MD, FRCSC - Otolaryngology
To learn more about Healthwise, visit Healthwise.org.
© 1995-2018 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.
Our interactive Decision Points guide you through making key health decisions by combining medical information with your personal information.
You'll find Decision Points to help you answer questions about:
Get started learning more about your health!
Our Interactive Tools can help you make smart decisions for a healthier life. You'll find personal calculators and tools for health and fitness, lifestyle checkups, and pregnancy.
Feeling under the weather?
Use our interactive symptom checker to evaluate your symptoms and determine appropriate action or treatment.
2700 Clay Edwards Drive, Ste 240, North Kansas City, MO 64116