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Tuesday, December 5, 2023

Understanding Nasal Septum Perforation: Causes, Symptoms, and Diagnosis

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The nasal septum is a vital structure that divides the nasal cavity into two separate passages. In some cases, this delicate septal tissue can develop a perforation, resulting in a condition known as nasal septum perforation. This blog will provide comprehensive information about nasal septum perforation, including its causes, symptoms, and treatments like nasal septum perforation surgery.

Causes of Nasal Septum Perforation

There can be a lot of causes for septum perforation, such as:

  • Trauma or Injury: Nasal septum perforation can occur due to direct trauma or injury to the nose. This includes nasal fractures, excessive nose picking, forceful nose blowing, or repeated irritation from wearing ill-fitting nasal devices.

  • Nasal Drug Abuse: Prolonged and excessive use of intranasal drugs, such as cocaine or certain prescription medications, can cause damage to the nasal septum, leading to perforation.

  • Medical Conditions: Certain medical conditions, including autoimmune disorders (such as lupus or Wegener’s granulomatosis), infections, tumours, or chronic nasal inflammation, can contribute to the development of nasal septum perforation.

Symptoms of Nasal Septum Perforation

Here are the primary symptoms of nasal septum perforation:

  • Nasal Discomfort: Individuals with nasal septum perforation often experience ongoing nasal discomfort, including dryness, crusting, and irritation. The perforation disrupts the normal airflow within the nasal cavity, leading to these symptoms.

  • Nosebleeds: Nasal septum perforation can cause recurrent nosebleeds, as the exposed septal tissue is more prone to bleeding.

  • Whistling Sound During Breathing: Air passing through the perforation can create a whistling or hissing sound during breathing. This audible symptom is more noticeable during inhalation.

  • Nasal Congestion: Some individuals may experience nasal congestion or a feeling of blocked nasal passages due to disrupted airflow caused by the perforation.

Diagnosis of Nasal Septum Perforation

  • Medical History and Physical Examination: Consulting a medical professional is the best approach; they will begin with taking a detailed medical history and conducting a physical examination of the nose. They will look for visible signs of perforation, assess nasal congestion, and evaluate other associated symptoms.

  • Nasal Endoscopy: Nasal endoscopy uses a thin, flexible tube with a light and camera (endoscope) to visualise the nasal passages. This allows the healthcare provider to directly examine the nasal septum and identify the presence and extent of the perforation.

  • Imaging Tests: In some cases, imaging tests such as CT or MRI scans may be ordered to obtain detailed images of the nasal structures. These scans can help determine the size and location of the perforation and identify any underlying causes or associated conditions.

Treatment Options for Nasal Septum Perforation

  • Conservative Management: In mild cases of nasal septum perforation, conservative measures may be recommended, such as lubricating nasal ointments and avoiding irritants.

  • Surgical Repair: Surgical repair may be necessary for severe perforation cases. Nasal septum perforation surgery aims to close the perforation and restore the normal nasal septum structure. Different surgical techniques are available, depending on the size and location of the perforation.

  • Endoscopic Septoplasty: In some cases, nasal septum perforation repair can be performed using endoscopic techniques. This minimally invasive approach allows the surgeon to access and repair the perforation through small incisions, resulting in less scarring and a faster recovery.

  • Mucosal Flap Reconstruction: A mucosal flap reconstruction technique may be employed in complex or large perforations. This involves using adjacent nasal mucosal tissue to create a new barrier, covering the perforation and promoting healing.

  • Symptomatic Management: While surgical repair is often the primary nasal septum perforation treatment, symptomatic management is crucial in alleviating associated symptoms. This may include using nasal saline rinses to maintain nasal hygiene, humidifiers to reduce dryness, and nasal moisturising sprays or ointments to relieve discomfort.

  • Follow-up Care: Following surgical repair, close monitoring and regular follow-up with the healthcare provider are essential. This allows for proper healing assessment, management of postoperative complications, and treatment plan adjustment if needed.

To Conclude

Nasal septum perforation is a condition that can significantly impact nasal health and overall well-being. Understanding the causes, recognising the symptoms, and obtaining an accurate diagnosis is crucial to effective management. While conservative measures can relieve mild cases, surgical repair is often necessary for more severe perforations.

Consulting with a qualified rhinoplasty specialist is vital to determine the most appropriate treatment approach, achieving optimal outcomes, and improving your quality of life.

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