Nasal septum perforation

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Nasal septum perforation
Synonyms	Septal perforation
Pronounce	N/A
Specialty	N/A
Symptoms	Nasal congestion, epistaxis, nasal crusting, whistling sound during breathing
Complications	Nasal collapse, saddle nose deformity
Onset	Varies
Duration	Chronic
Types	N/A
Causes	Trauma, surgery, cocaine use, autoimmune diseases, infections
Risks	Nasal trauma, substance abuse, surgical history
Diagnosis	Nasal endoscopy, CT scan
Differential diagnosis	Nasal septal hematoma, nasal polyps, sinusitis
Prevention	Avoidance of nasal trauma and irritants
Treatment	Saline irrigation, topical ointments, surgical repair
Medication	N/A
Prognosis	Varies depending on cause and treatment
Frequency	Unknown
Deaths	N/A

Nasal septum perforation is a medical condition characterized by a hole or fissure in the nasal septum, the cartilage and bone that separates the two nostrils. This condition can lead to various symptoms and complications, depending on the size and location of the perforation.

Causes

Nasal septum perforation can result from several factors, including:

• Trauma: Physical injury to the nose, such as from a nasal fracture or repeated nose picking.
• Surgery: Complications from nasal surgeries like septoplasty or rhinoplasty.
• Infection: Chronic infections such as syphilis or tuberculosis.
• Inflammatory diseases: Conditions like Wegener's granulomatosis or sarcoidosis.
• Drug use: Inhalation of drugs, particularly cocaine.
• Chemical exposure: Prolonged exposure to certain chemicals or irritants.
• Cancer: Tumors in the nasal cavity.

Symptoms

The symptoms of nasal septum perforation can vary but often include:

• Nasal congestion
• Nosebleeds (epistaxis)
• Crusting inside the nose
• Whistling sound when breathing
• Nasal discharge
• Decreased sense of smell (hyposmia)

Diagnosis

Diagnosis typically involves a physical examination by an otolaryngologist (ENT specialist). The doctor may use a nasal endoscopy to visualize the perforation. Additional tests, such as CT scans or MRI, may be required to determine the underlying cause.

Treatment

Treatment options depend on the size and cause of the perforation:

• Medical management: Includes nasal saline sprays, ointments, and humidification to keep the nasal passages moist.
• Surgical repair: Involves procedures like septal button insertion or flap surgery to close the perforation.
• Avoidance of irritants: Patients are advised to avoid nasal irritants, including smoking and drug use.

Complications

If left untreated, nasal septum perforation can lead to:

• Chronic nasal infections
• Persistent nosebleeds
• Nasal deformity
• Breathing difficulties

See also

• Nasal septum
• Septoplasty
• Rhinoplasty
• Epistaxis
• Otolaryngology

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