CAN THIS BE REPAIRED. WHAT IS PROGNOSIS
Reply: -------------------
In order to successfully manage and properly treat a nasal septal perforation, it is important to identify the probable cause of the perforation. Nasal septal perforations may be the result of intranasal drug abuse, chronic use of topical non-prescription vasoconstricting nasal sprays such as Afrin or Neo-synephrine, nasal injuries, prior nasal surgery, chronic "nose-picking", chronic nose-bleeding with the need for frequent cautery, malignancy, granulomatous conditions (eg Wegener's granulomatosis), unusual infections, or other systemic conditions. Overall treatment regimens will then be determined by the underlying cause.
Some septal perforations do not really require any treatment other than the use of nasal saline sprays for moisturization. Some of the bothersome symptoms of septal perforations include crusting, nose-bleeding, nasal airway obstruction, audible whistling during nasal breathing, nasal drip, etc. Very large septal perforations are frequently associated with an external nasal deformity typically referred to as a "saddle-nose" commonly seen with boxers who have had frequent nasal injuries.
Mildly symptomatic nasal septal perforations can often be managed simply with proper attention towards humidification and the use of topical nasal saline sprays (Ocean, Nasal, Ayr, etc.) or nasal emollient solutions (Ponaris, Pretz) or nasal gels (Ayr saline gel,K-Y jelly).
More symptomatic individuals not adequately treated by the above approaches may be treated non-surgically with a prosthesis known as a septal button which is a silastic disc inserted into the perforation inside the nose.
There are a number of surgical methods available for closing septal perforations. The success of surgical closure of septal perforations is largely dependent upon the underlying cause of the perforation, cigarette smoking or other active medical conditions, and the size of the perforation (the larger the perforation, the more difficult to close).
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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