nasal septum perforation treatment in Melbourne and Regional Victoria
Septal Perforation Repair
Septal perforation is a condition where there is a hole or a perforation in the nasal septum, which is the thin wall of cartilage and bone that separates the two nostrils.
What causes nasal septal perforation and how is it treated?
Septal perforations can be caused by a variety of factors. Some of these include:
- Trauma to the nose from sports injuries, accidents or surgery. These can result in a septal haematoma where a blood clot forms under the lining of the septum and leads to necrosis or breakdown of the septal cartilage leading to a septal perforation.
- Digital trauma and nose picking can lead to septal perforations
- Chronic nasal infection or inflammation
- Systemic inflammatory conditions such as allergic rhinitis
- Inhalational irritants such as cocaine use
Medical management for septal perforation may include surgical and / or conservative measures such as humidification, topical antibiotics and nasal sprays.
Diagnosing a septal perforation
A septal perforation is typically diagnosed through a physical examination of the nasal cavity. Your ENT specialist will use a nasal endoscope to assess the size and location of the perforation and evaluate the surrounding tissue.
In some cases, further investigation may be required to identify the underlying cause, particularly where autoimmune or inflammatory conditions are suspected. This may include blood tests or a small tissue biopsy.
Understanding the cause and extent of the perforation is an important first step in determining the most appropriate treatment pathway for each patient.
Symptoms of a perforated septum include:
- Nasal congestion
- Nasal crusting
- Difficulty breathing
- Frequent nosebleeds
- Altered sense of smell
- Whistling sounds when breathing
A hole in the septum can also change the external shape of the nose, leading to saddle nose deformity (collapsed nasal bridge) and loss of nasal height. This is more common when there is a larger perforation.
However, depending on the size and location of the septal perforation, some patients may have no symptoms at all.
Perforated septum surgery
Septal perforation repair is a reconstructive surgical procedure. This nasal surgery aims to close the perforation and restore the normal structure of the nasal septum. The procedure involves creating a local flap of tissue from the nasal mucosa (the lining of the nasal cavity) and using it to cover the perforation. The flap typically can be either based on the anterior ethmoid artery, or the nasoseptal artery. These special fashioned flaps utilises blood vessels within them to improve blood supply and higher chance of healing. The flap is then secured in place with sutures, and sometimes supported with additional tissue or materials. For example, cartilage grafts or synthetic implants.
A septal button is a less frequently used technique where a prosthetic is used to fill the hole in the septum. Septal repair surgery is usually done as a day procedure under a general anesthetic.
What to expect from your consultation
Before progressing with any treatments at our practice, we want you to have all the information you need to make an informed decision. It’s important you know exactly what to expect.
Every case is different. If you’re in Melbourne or regional areas of Victoria, we invite you to contact us for a consultation. We will discuss all your options and help you feel empowered to take the next step.
Fast appointments for septal perforation
We’re HotDoc integrated which means you can book and schedule an appointment online or via mobile any time of night or day. We aim to accommodate urgent GP referrals within 24 hours.
Where can I make an appointment
To help ensure our ENT services are accessible for all Victorians, we consult at various locations across metropolitan Melbourne and regional Victoria.
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Frequently Asked Questions
In rare cases, a small amount of tonsil tissue can regrow, but this is uncommon and usually doesn’t cause problems.
A tiny nasal perforation may heal on its own. Although, as the size of a hole in the septum increases, the likelihood of healing spontaneously, decreases. That’s why nasal septal perforation repair is often necessary to remedy this condition.
ENT Surgeons, also known as Otolaryngologists, have specialist training and skills to perform surgery inside the nose. Some ENT Specialists have additional skills and training in nasal surgery and facial cosmetic surgery. This may help to achieve a better cosmetic result in addition to repairing the function of the septum. During your consultation with a specialist, they will discuss the surgery process, associated risks and recovery times.
After surgery, patients may have nasal splints or packing in the nose to help with the healing of internal nasal structures. Patients typically return to work after a few days of rest. Our team will explain what to expect in more detail during initial consultation.
How to take the next step
If you are experiencing symptoms of septal perforation, or think you may have a perforated septum and want to understand more about treatment and surgical options, contact us today or make an online booking with Dr. Yi Zhao.
Dr Yi has taken additional sub-specialist fellowship training in managing the disease of the nose with one of the world’s leaders in the field of Rhinology (all aspects of nose and sinus disease). He is also a Member of the Australasian Academy of Facial Plastic Surgery.
He will be able to perform a thorough examination and provide guidance as to the next steps forward.
