How Do I Deal with a Giant Hole Through my Nasal Cartilage (Due to 4 Years of Snorting Drugs Daily)?

Its gotten substantially worse in recent months-I've probably an inch of cartilage left-the damage is worsening rapidly. Only when I TOTALLY cleaned out my nose recently did I realize the buildup of perc had made it APPEAR smaller. The damage had started long before I had actually detected it-Once I had an unblocked view I became aware of the full impact of damage done. Aside from the minimal cartilage at the front, its just one gaping hole inside instead of 2 single passageways. Please help! :(

Doctor Answers 2

Repair of septal perforation due to drug use

It is very difficult to repair a septal perforation with surgery, as there simply is not enough skin or cartilage present to repair large holes.  The best alternative at this point is placement of a septal button which is a silastic implant held in place with permanent sutures.  It is important that all use of recreational drugs is discontinued or, surgery is not indicated.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Hole in septum

The most important question is how did it get there.  The most common reason is prior surgery.  Topical nasal sprays are another especially decongestants such as afrin.  Cocaine use, aggressive nasal picking, and cauterization for bleeding are notorious.  Assuming that none of these causes are present then other conditions need to be considered:  autoimmune disease, syphilis, and Wegeners granulomatosis that can be assessed by blood testing.  Small cell and other cancers can also destroy the septum:  these would be diagnosed by biopsy.  To treat the crusting and bleeding I suggest saline rinses followed by pharmaceutical grade sesame oil for moiturization 2-3 times daily

Mark Loury, MD, FACS
Fort Collins Facial Plastic Surgeon
4.8 out of 5 stars 18 reviews

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