Introduction The nasal septum is a wall attached to the cartilage and bone standing between the two nostrils, which helps regulate airflow and keep the structure of the nose. When this fine structure in the nose gets a hole or tear, the result is septal perforation. It might lead to difficulty in breathing, regular nosebleeds, and massive amounts of discomfort, thereby affecting the lifestyle of a person. What is a Septal Perforation? Septal perforation is a hole in the nasal septum, which is the thin structure made of bone and cartilage that divides the nasal cavity. The variation in size is usually from small to large, with the effect being from mild discomfort to quite serious health issues. A small perforation might not even be symptomatic at all, while larger ones are functionally symptomatic and include chronic infections, trouble breathing, and cosmetic changes. Causes of Septal Perforation A septal perforation may result from several factors, which include: Trauma: Of the more common etiologies, it could occur due to accidents, sports trauma, and even nasal procedures that are overly aggressive like cauterization or surgical interventions. Surgery Complications: After septal surgery, commonly referred as septoplasty or rhinoplasty perforations may take place as a surprise particularly when the vascularity of the septum has been compromised. Chronic Inflammations: Chronic sinusitis or infections affect the nasal tissue adversely and contribute to perforation of the septum. Autoimmune Disorders: Specific autoimmune disorders, such as granulomatosis with polyangiitis or lupus, are other causes of septal perforation that result from the autoimmune system's attack on the body's healthy tissues. Infection: Bacterial or fungal infections, especially those that linger for some time, may break down nasal tissue and cause perforation. Tumors: Tumors, least of all cancerous growths, in the nasal cavity are very rare causes of septal perforation. Symptoms of Septal Perforation The symptoms of septal perforation are of varying nature and mainly depend on the size and location of the perforation. The commonest symptoms are: Nosebleeds: Irritation of the blood vessels around the perforation is not uncommon from frequent, unexplained nosebleeds. Whistle: Many patients develop a prominent whistling sound while breathing, particularly if the perforation is of small size. Nasal Congestion: Sometimes, people feel like their nose cavities are somehow congested or blocked all the time, which becomes really burdensome for them to breathe consecutively. Crusting and Scabbing: In the case of denuded cartilage or bone within the perforation, the overlying tissue of the lung mucosa may desiccate, which leads to crusting and scabbing of the nose. Septal perforation diagnosis If you suspect that you have an injury which might cause a septal perforation you should make an appointment with your family ENT (otolaryngologist) who will refer you to have the medical evaluation. Diagnosis is a process that involves : History: The doctor will ask you regarding your symptoms, past history of nasal trauma, any surgery, or substances of abuse. Physical Examination: Your doctor will use a nasal speculum and bright light to examine your nasal cavity for any views of perforation. Endoscopy: For further localization and visualization, nasal endoscopy may sometimes be required to examine the nasal cavities and the septum more closely. A very narrow tube, attached to a micro-camera, is inserted into the nose to present the images in detail. Conclusion The condition is very serious, grossly debilitating, and may have effects on daily life. Symptoms can range from mild discomfort to possible life-threatening conditions, which are due to trauma, surgical intervention, or even underlying medical conditions. Fortunately, the advancement of these medical and surgical treatments led to the establishment of diverse ways in the management and repair of septal perforations. When one thinks they might be experiencing a septal perforation repair, you should see a specialist for discussion of symptoms, diagnosis, or treatment options suitable to each individual.
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