Septum Perforation (Hole in the Nasal Septum)
The nose is one of the most essential parts of our respiratory system. It regulates airflow, warms and humidifies the air, and filters out germs and dust particles. The structure dividing the nasal cavity into two parts and regulating airflow is called the “septum.” Septum perforation occurs when a hole forms in this structure, negatively affecting nasal functions and impacting both health and quality of life.
Causes of Septum Perforation
There are numerous causes of septum perforation, often triggered by multiple factors. Below are the most common causes:
Nasal Surgeries
Individuals who have undergone nasal surgery are at higher risk of septum perforation. Procedures like rhinoplasty, deviation, or sinus surgeries may unintentionally damage the septum. Improperly healed tissues post-surgery can evolve into a perforation over time.
Long-Term Nasal Spray Usage
Overusing nasal sprays for congestion can harm nasal mucosa, leading to a hole in the septum. Improper use of nasal sprays dries and thins the inner nasal tissues.
Exposure to Chemicals
People working in chemical environments or exposed to significant pollution face increased risk. Chemicals damage the nasal mucosa, weakening the tissue.
Trauma and Nasal Injuries
Accidents, fights, or sports-related injuries can damage the septum. A strong blow to the nose may lead to cracks or subsequent perforation.
Drug Usage
Substances like cocaine and ketamine ingested nasally severely damage delicate nasal tissues. Over time, this results in septum perforation. Cocaine particularly disrupts blood flow in the nasal mucosa, leading to tissue death.
Infections
Untreated nasal infections, especially fungal or chronic bacterial ones, can cause significant damage, leading to perforation.
Smoking
Smoking dries the nasal mucosa and hinders tissue healing, weakening the septum and causing holes.
Autoimmune Diseases and Genetic Factors
Certain genetic conditions or autoimmune diseases may weaken nasal tissues. Septum perforation is often observed in diseases affecting the immune system.
Symptoms of Septum Perforation
The symptoms of septum perforation vary depending on the hole’s size and location. Perforations disturb the laminar airflow within the nose, leading to various discomforts. Common symptoms include nasal dryness, congestion, nosebleeds, crusting, foul-smelling discharge, headaches, post-nasal drip, cartilage inflammation, and whistling sounds during breathing. Large perforations may cause nasal tip drooping and infections. Some individuals remain asymptomatic, while others experience severe discomfort. The most common symptoms are:
- Nasal Dryness and Crusting: A hole in the nasal septum disrupts airflow, causing dryness and discomfort.
- Nosebleeds: The perforation area is often sensitive, making nosebleeds frequent.
- Whistling Sound While Breathing: Holes in the front of the septum may create whistling sounds during breathing.
- Headaches and Post-Nasal Drip: Altered airflow can affect sinuses, leading to headaches and post-nasal drip.
- Foul-Smelling Discharge: Infections may result in a smelly discharge.
- Cosmetic Issues: Severe perforations may alter nasal support, causing bridge collapse or tip droop.
How is Septum Perforation Diagnosed?
Diagnosis is typically made by an ENT specialist through nasal endoscopy. This painless and brief procedure helps visualize the septum’s perforations, including those in the rear part of the nasal cavity. Imaging such as CT scans may be recommended to assess accompanying sinus issues before repair.
Treatment Methods for Septum Perforation
Treatment depends on the size and location of the perforation, the severity of symptoms, and the patient’s general health. Asymptomatic cases may not require treatment, but symptomatic cases initially benefit from nasal irrigation and moisturizing medical methods. If symptoms worsen, surgical intervention becomes necessary.
Surgical Treatment
Perforations that cause symptoms and reduce quality of life are often treated surgically. The success of the operation depends on the hole’s size, location, and the remaining cartilage support. For successful outcomes, surgeons must consider the perforation’s cause, size, and surrounding tissue condition. The expertise and experience of the surgeon play a crucial role in the procedure.
Special Techniques in Septum Perforation Surgery
What sets Prof. Dr. Gediz Murat Serin apart?
- Dr. Serin applies a unique surgical technique for more successful and lasting outcomes. This method, published in medical literature, has garnered positive feedback from patients.
- Using tissue from the patient’s leg, the perforation is repaired through endoscopic or open techniques, depending on the case. For some patients, rib cartilage may be used for added support.
- Dr. Serin’s techniques have improved success rates to over 80%, offering an effective and promising solution for patients with septum perforations.
Postoperative Care
Post-surgery, patients should take precautions to ensure proper healing:
- Protect the nose from trauma.
- Avoid smoking and irritants.
- Maintain nasal cleanliness and moisturization.
- Follow prescribed medications diligently.
Conclusion
Septum perforation is a serious condition that can adversely affect quality of life. With proper diagnosis and treatment, the problem can be entirely resolved. If you experience symptoms like nasal congestion, bleeding, or whistling sounds, consult a specialist. Remember, taking care of your nasal health is critical to your overall well-being.
