What is Septum Perforation?

Septum perforation is a hole or opening that occurs in the nasal septum, the cartilage and bony tissue that divides the nasal cavity into two. This hole can hinder breathing and cause serious problems for nasal health. Damage to this structure, which forms the middle part of the nose, can lead to both aesthetic and functional issues. This condition can block the natural airflow through the nose, leading to various symptoms.

How Does Septum Perforation Occur?

Septum perforation can arise from various reasons. Trauma, surgical interventions, infections, or chronic conditions can lead to the formation of a hole in the septum. Septum perforations are usually not noticed at first, and over time, symptoms such as breathing difficulties, nosebleeds, and infections may occur.

What Causes Septum Perforation?

Septum perforation can arise from various factors. Some factors that weaken the septum include:

• Trauma: Blows or accidents in the nasal area can cause damage to the septum.
• Surgical procedures: Complications after rhinoplasty or other nasal surgeries can lead to septum perforation.
• Chronic infections: Prolonged nasal infections can weaken the septal tissue and lead to a hole.
• Chemical exposure: Excessive use of tobacco or exposure to chemicals can lead to the breakdown of the nasal mucosa.
• Autoimmune diseases: Autoimmune diseases such as lupus and Wegener’s granulomatosis can cause damage to the septal tissue.

Regardless of the cause of septum perforation, it should be taken seriously, and a specialist should be consulted.

Symptoms: How to Recognize Septum Perforation?

Septum perforation may initially present with mild symptoms. Over time, more severe symptoms may develop. The most common symptoms of septum perforation are:

• Breathing difficulties: The hole in your nose affects airflow, making breathing more difficult.
• Bloody noses: Irritated blood vessels in the perforation area may bleed frequently.
• Dry nose: Disruption of the moisture balance in the nose can lead to dryness and crusting.
• Wheezing sound: The hole in the nostrils may cause wheezing sounds during breathing.
• Infections: Due to the normal structure of the nose being disrupted, septum perforation can lead to recurrent infections.

If you experience any of these symptoms, consider the possibility of septum perforation and consult an ENT specialist.

The Decision-Making Process for Septum Perforation Surgery

Once the diagnosis of septum perforation has been established, treatment options need to be evaluated. Whether surgical intervention is necessary depends on the size of the perforation and the complaints of the patient. Key considerations for deciding on a septum perforation surgery include:

• Size of the perforation: Small perforations usually do not require surgical intervention. However, larger holes can severely impact breathing.
• Severity of symptoms: If symptoms are mild, non-surgical treatments may be attempted. However, severe symptoms may require surgery.
• Quality of life: Perforations that cause breathing difficulties, frequent nosebleeds, or recurrent infections should be surgically repaired.

Before considering surgery, discuss all options with your treating physician and obtain detailed information about the necessity of the procedure.

Preparations for the Surgery

After the decision for a septum perforation surgery has been made, the pre-operative process begins. It is crucial to follow your doctor’s instructions. Important points to consider before the surgery:

• Medical history: Inform your doctor about your complete medical history. It is important to provide detailed information about allergies, medications, or previous surgeries.
• Blood tests: Necessary blood tests and imaging techniques may be performed before the surgery.
• Medication: The use of aspirin and blood-thinning medications should be discontinued before the surgery.
• Smoking: If you smoke, quitting before the surgery will positively affect your recovery process.

Preparing your body and mind for the surgery will accelerate the healing process.

How is Septum Perforation Surgery Performed?

The surgery for septum perforation should be performed by an experienced ENT surgeon. The general steps of the surgery are as follows:

• Anesthesia: The surgery is performed under general anesthesia. This ensures that the patient feels nothing during the procedure.
• Repair of the perforation: Once the surgeon accesses the perforation, the hole is repaired. Typically, a grafting technique is used to close the hole in the septum.
• The graft may be taken from the patient’s own tissue, or synthetic materials may be used.
• Sutures: After repairing the hole, sutures are placed, and nasal tampons are inserted. These tampons help keep the nose stable during the healing process.

The duration of the surgery depends on the size of the perforation and the overall health status of the patient, but it typically lasts 1-2 hours.

Recovery Process After the Surgery

The recovery process after surgery requires both physical and mental preparation. Important considerations after surgery include:

• Rest: You should rest for the first few days to support your body’s healing process.
• Removal of nasal tampons: The nasal tampons will be removed by your doctor within a few days.
• Pain management: Mild pain after surgery is normal. The pain relievers recommended by your doctor can be used.
• Infection prevention: Nasal infections can negatively impact the healing process. It is important to pay attention to nasal hygiene after the surgery.

Follow your doctor’s recommendations during the recovery process to achieve a successful outcome.

Possible Complications After the Surgery

As with any surgical procedure, there are some risks associated with septum perforation surgery. Possible complications that may occur after the surgery include:

• Infection: An infection may occur at the surgical site. This can be treated with antibiotics prescribed by your doctor.
• Wound healing problems: In some patients, wound healing may proceed more slowly or complications may arise.
• Recurrence of perforation: In rare cases, a perforation may occur again in the repaired septum.
• Bleeding: After the surgery, nosebleeds may occur. In this case, you should contact your doctor.

It is crucial to closely follow your doctor’s recommendations to prevent these complications.

Important Considerations After Septum Perforation Surgery

To accelerate the recovery process and avoid complications, several important points should be taken into account:

• Avoid heavy physical activities: Avoid heavy physical activities in the first weeks after surgery.
• Nasal hygiene: Follow the nasal hygiene recommended by your doctor.
• Avoid smoking and alcohol: Refrain from smoking and consuming alcohol, as they can negatively affect the healing process.