The nasal septum or septum is the structure that separates the inside of the nose into two cavities or nostrils. In addition to directing the flow of air into each nostril, the mucosa lining the septum has the function of hydrating and warming the air passing through the nose, making it optimal for the lower airways.
In some cases, nose surgeries such as rhinoplasty, septoplasty or sinus surgery cause a septal perforation. The septum can also be perforated as a consequence of nasal drug use, cocaine being the most common, or by trauma and recurrent manipulation of the septum with the finger or “picking”.
What are the complications of a septal perforation?
The most frequent symptoms of a perforated septum are nasal dryness, epistaxis or bleeding and the formation of crusts that many times make breathing difficult.
When the perforation is very large it can generate a deficiency in the support of the nose, causing the dorsum of the nose to fall. This causes an external deformity called saddle nose.
Types of treatment for septal perforation
Firstly, conservative treatments such as nasal washes with saline or sea water are recommended, as well as the use of ointments containing vaseline and vitamins.
Secondly, and if the conservative treatment does not work, the perforation is repaired surgically, since surgery is the only treatment that can restore the physiological function of the septum. The surgical technique will vary according to the characteristics of the perforation presented by each patient.
Very large or total perforations, that is, those larger than 4.5cm, are very difficult to repair and have a worse prognosis.
Preparation and recovery after surgery
Before surgery it is essential to avoid manipulation of the septum with fingers or handkerchiefs and to keep it hydrated with washes and ointments.
Surgical treatment can be performed by a minimally invasive endoscopic approach, so the postoperative period is usually very bearable and fast. However, it is necessary to keep small silicone sheets inside the nose for at least 4 weeks to ensure proper healing of the septum. These do not generate significant discomfort in the patient, since they can perform daily activities normally and are not visible on the outside.