What are the chances of a septal perforation?

Question

I am very concerned about a potential Septal Perforation after a septoplasty, my doctor uses a conservative endoscopic approach however I am still quite concerned about the potential of a perforation. What are the chances of a perforation in a young 21 year old male who is in good shape, doesn't smoke, drink or use drugs. Etc..?

Jacob Tower, MD · Answer

Good morning, in experienced hands the risk of septal perforation with septoplasty is generally quite low. I explain to patients that revision nasal surgery, smoking, and inhaled substances (e.g. cocaine use) substantially increase that risk. It sounds as though you do not fall into any of those categories. Having said that, even in well-executed septoplasty there is always a small, but non-zero chance of perforation which we have to accept as the nature of the surgery. And finally, if something like this happens and results in significant symptoms (oftentimes small perforations are asymptomatic), techniques exist to repair these complications. 
Best Regards,Jacob Tower, MD

Nima Shemirani, MD · Answer

Hi @Considerate83669! The chances of a septal perforation are quite low especially with an experienced surgeon. I would not worry. Best of luck, Dr. Nima!

Robert Ciardullo, MD · Answer

How likely is septal perforation with septoplasty? overall the rate of septal perforation with septal surgery is extremely low. In some cases septoplasty involves straightening of the Cartilage or repositioning it in the midline without removing any Cartilage. In those cases there is no chance of septal perforation. When a portion of Cartilage is removed, which is called submucous resection , There is a very small risk of septal perforation probably one or 2%. If a septal perforation is small it may cause a slight whistling sound when breathing. In some cases there may be a small amount of bleeding periodically. But in most cases the septal perforation would be asymptomatic and you might not even be aware that you have one. There are currently procedures to repair septal perforations if a patient so desires. Overall the small risk should not outweigh the benefit in patience with septal deviation significant enough to Impair the airway.

Thomas Spalla, MD · Answer

The rate of septal perforation is quite low - especially in experienced hands. You don't sound like you have risk factors to increase this low rate of complication.Rates are quite low and when perforations do occur, a lot of them are asymptomatic and patients are unaware that they are present. So, even when they do occur, it's often of no consequence.
If you need/would benefit from a septoplasty, don't let these low rates hold you back from the potential of permanent improvement in your nasal breathing.

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

Hello! Thanks for your question. The rate of septal perforation is very low overall. It depends on who is reporting the number. In general, I would say it's under 5%. In a patient in good health and in the hands of a competent surgeon, the rate is very, very low. Hope this helps.

What are the chances of a septal perforation?

Answers (5)

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