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How common is a septal perforation after septoplasty and how can it be treated?

How common is a septal perforation after septoplasty and how can it be treated?

Posted by Dr. Litner and Dr. Solieman on March 21st, 2014

The short answer to this question is: it is not common. However, septal perforation can happen and is more likely to be a risk for those with a history of nose surgery and/or those with a severely damaged or deviated septum. If you are considering a septoplasty and are concerned about the risks of a septal perforation, it is important to understand some basics facts about the anatomy and septal repair.

A deviated septum and septoplasty. The nasal septum is the thin bone and cartilage wall that separates the nasal passages. Generally straight, the septum can be displaced. Known as a deviated septum, this common condition can be present at birth or can arise due to an injury or other trauma to the nose. If severe, a deviated septum can obstruct breathing, making day-to-day life uncomfortable for the individual with the crooked septum. A corrective nose surgery, or septoplasty, can be performed to straighten the septum and alleviate any breathing problems and other symptoms associated with a deviated septum.

General causes of septal perforations. A septal perforation—or a puncture in the septum—can appear due to a number of non-surgical reasons, including:

  • Nasal fracture or trauma to the nose
  • Excessive use of nasal steroids and/or nasal decongestants
  • Snorting cocaine and/or other drugs
  • Digital nose cleaning (nose picking)
  • Cancer
  • Diseases such as tuberculosis or syphilis

Nose surgery and septal perforations. Overall, a septoplasty is considered a safe procedure. Although it is commonly performed, it is also a very delicate surgery, which requires numerous skills. Occasionally, a septoplasty procedure can result in a complication and, in rare instances, cause a septal perforation. It is important to note that a septal perforation is generally more likely to occur in the case of a revision surgery (a secondary septoplasty) or when a patient suffers from a severe deviated septum.

If a septal perforation does occur after surgery, it is important to have it evaluated and treated. If left untreated, a septal perforation can worsen and become more complicated to repair. A variety of treatments are available, depending on the location, size, and severity of the septal perforation. Minor septal perforations may respond to therapeutic treatments, such as emollients, and may not need to be repaired. Some surgeons may recommend plugging the perforation with a silicone prosthesis called a septal button. However, these buttons can irritate the lining around the perforation, leading to further complications and, for that reason, are not recommended by Drs. Solieman and Litner. For more complicated cases, surgery may be necessary to close the perforation.

Although a septal perforation can be the result of complications from nose surgery, such as a septoplasty, the overall risk of developing one is low. If your doctor determines that your septal perforation needs repair, it is better to address it than not have it treated. The risk of inaction can outweigh the risk of treatment. However, be sure to see a surgeon who has a track record of successfully treating patients with septal perforations.

If you suspect you have septal perforation or have already been diagnosed with one, it is best to have your nose fully evaluated and treated by surgeons with expertise in septal perforation repair. With specialized training and impressive case histories, Drs. Litner and Solieman are uniquely qualified in this area of nose repair. Contact them at their office at Profiles Beverly Hills to schedule a consultation.

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