Nasal Septum Perforation: Causes, Symptoms And Treatment

Cocaine users are particularly at risk of developing the problem of nasal septum perforation. However, this is not the only factor that can cause this condition. In this article, we explain everything about this medical condition.

Nasal septum perforation is a pathology that affects the nose. In some cases, this problem may not cause any symptoms. Even then, however, it is associated with a high risk of complications.

The prevalence of the condition is increasing because its predominant causes are cocaine use and some surgical procedures such as septoplasty. Both situations are very common today.

Septal perforation may require medical or surgical treatment. In this article, we explain everything you need to know about it.

What is a nasal septum perforation?

The nose is a complex structure necessary for the proper functioning of the breathing process. It has two openings called nostrils that filter the air. This way, it can reach the lungs cleaner, moist and warmer, preventing infections or injuries.

The nostrils are separated by a nasal septum. It is the structure of cartilage and bone that vertically divides the nose. Creates the inner face of both holes. Thus, it facilitates the flow of air.

A nasal septum perforation is the formation of a defect in this part of the nose. Depending on how large the opening is, more or less severe symptoms may occur.

The reasons for the perforation of the septum

The etiology of this disease is very diverse. This is because, as a partially cartilaginous structure, it is sensitive to certain factors that can negatively affect tissue.

One of the most common causes of this problem is surgery in the nose area. Perforation can appear as a complication of rhinoplasty, especially when this is done to eliminate breathing problems.

Rhinoplasty is an operation that allows you to modify the shape of the nose, both for aesthetic purposes and to improve the quality of breathing.

On the other hand, as explained in the MSD manual, it can also appear after an infection or trauma. Here we could include interference in the nose area – even the placement of an earring that goes through the septum.

Other reasons for this problem

Another of the most important causes is nasal drug use. Cocaine is associated in particular with this pathology. According to research carried out at the Hospital of Santa Creu and Sant Pau, it is currently one of the main causes of this phenomenon.

This substance causes the blood vessels in the nose to constrict. Then, due to an insufficient amount of blood, the tissue is damaged and may be punctured.

However, not only drugs carry a risk of septal perforation, but also many other factors. For example, some corticosteroid-based medicated sprays, so does the use of pure oxygen through a nasal mask or goggles.

Finally, another cause of this pathology is exposure to chemicals or toxic substances. This mainly happens with people working in the chemical industry or factories.

What symptoms does a nasal septum perforation cause?

Symptoms of septal perforation depend on the size of the resulting defect. It can be very small, less than one centimeter, or even reach two centimeters.

If symptoms appear, usually based on recurrent bleeding from the nose (lat. Epistaxis ). They can be profuse and disturbing because the nostrils are very vascularized.

In some cases, a runny nose, i.e. a discharge from the nose, appears instead of bleeding. In addition, it is common for scabs to form around the opening, leading to a feeling of obstruction when breathing, as if the nostrils are blocked.

Also common to those struggling with this problem is the experience of a headache or noseache. Another characteristic symptom of septal perforation is wheezing. It is similar to a squeaking sound like a hiss and occurs when you breathe. This is because air passes through the opening with each inhalation or exhalation.

Finally, the perforation of the septum can have aesthetic consequences. According to the Heredian Medical Journal, this pathology can cause – and it is in most cases – a developmental defect in the form of a deformation of the external nose. Then the tip of the nose begins to point downwards.

Treatment

There are different ways to treat this pathology. The choice depends on the symptoms and the size of the opening. In many cases, a medical approach is sufficient. An ointment made of bacitracin or mupirocin is used. These are substances that soothe scabs in the cavity area.

Saline solution can also be used. It should be administered by nasal spray. Like the ointment, it helps to reduce the formation of scabs and ulcers.

In some cases, surgery is necessary. To perform it, tissue from a different part of the patient’s body can be used. Sometimes artificial materials are also used to seal the hole.

Other surgical procedures

An alternative surgical procedure involving the reconstruction of the nasal septum is performed at the Hospital Clinic in Barcelona. This procedure uses a flap taken from the fibrous tissue surrounding the skull (this is called a pericranial flap).

First, an incision is made on the scalp from where the tissue is collected. Then an opening is made through the frontal bone. From there, tissue is inserted until it is positioned over the nasal cavity. In this way, the entire partition is formed and the perforation is removed.

The advantage of this method is that it is painless and the patient recovers quickly. In addition, there are no visible scars – the scar is only on the back of the skull, but is masked.

How is a nasal septum perforation diagnosed?

To diagnose septal perforation, a doctor needs to know the symptoms and observe the nasal cavity. For this reason, complementary studies are used to clearly see the inside of the nose.

One of the most commonly used methods is endoscopy. It involves the insertion of a small tube that carries the camera through the nostrils. In addition, other tools can be introduced through this tube that help remove the scabs. You can even take tissue samples.

One of the most useful diagnostic tests is computed tomography, according to a study published in the Journal of Radiology. Especially in cocaine users.

The perforation of the nasal septum can be avoided

It is important to know and remember that perforation of the septum can be prevented in many cases. It usually appears as a result of intranasal use of drugs or irritants.

Therefore, in addition to avoiding these habits, it is important to protect your nostrils if you work in the chemical industry or factories. In addition, you should always consult your doctor if you experience some of the symptoms we have listed.