Septal perforation about 2-2.5cm - what are the chances of saddle nose?

Question

Hello. I have an anterior septal perforation about 2-2.5cm in size. It is completely asymptomatic and I have no problems with it. However, I am terrified of getting saddle nose. The perforation has not gotten worse since it was diagnosed (months ago). septal perforation about 2-2.5cm in size I am scared to even rub my nose too hard in fear of causing this.

Ronald J. Edelson, MD · Answer

That’s a pretty big perforation. It would only cause a saddle nose if the perforation is close to the bridge. If it is low down it far back you don’t need to worry

John Michael Thomassen, MD · Answer

As long as the perforation is at least 1 - 1.5 cm from the dorsal septum, the septum should be strong enough to support your nose without collapsing.

Jeffrey H. Spiegel, MD · Answer

Truly, this may not be a problem.  It depends upon where the perforation is located.  There are some areas where there is an issue, and some where you can live your whole life with this safely.  Come see a facial plastic surgeon for an opinion, or a repair if needed.

Thomas Spalla, MD · Answer

First, how did you acquire the perforation? That's something that needs to be understood and discussed with an experienced nasal surgeon. This is important to ensure no ongoing process is present which could make progress in size.
Second, the amount of remaining dorsal cartilage strut determines your tendency to a saddle nose deformity. The amount in the caudal strut would affect tip support. (as general principles)
Consult with a surgeon is evaluate the above issues and determine if you are at a higher than average risk for future saddle nose deformity.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hi there! Septal perforations can be challenging to manage. A 2-2.5 cm perforation is substantial in size. The fact that you're asymptomatic is a good thing. The most important ways to prevent a saddle nose from developing are consistent follow-up with an ENT or facial plastic surgeon familiar with septal perforations and hydration of the tissues. If the perforation continues to change over time, then that is concerning and may require further workup or surgery. If it remains stable, then routine follow-up and hydration may be all that is needed. In the meantime, using saline gels and sprays, in addition to humidifiers at night, can help with creating stability of the perforation. Hope that's helpful.

Septal perforation about 2-2.5cm - what are the chances of saddle nose?

Answers (5)

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