Septal Perforation Repair : Why do the success rate differ from physician to physician?

Question

I have a roughly 5mm x3mm anterior perforation. So I have read several academic journals stating that perforated septum are hard to repair. Some of them detailing that the success rate of this procedure is anywhere between 40-60% due to the avascular nature of the cartilage. While other journals state that the success rate is quite high anywhere from 85% and up. My potential surgeon wants to operate on this perforation. What are the chances that this procedure will fail?

Eric M. Joseph, MD · Answer

The rationale for repairing a septal perforation is to improve whistling, crusting, and nasal dryness. If there are no symptoms, or just mild dryness, it may be best living with it. The success of septal perforation repair also depends on the ability of your surgeon to free up enough nasal mucosa to close the hole with sutures completely, at least on one side. I believe successful repair of a septal perforation amenable to treatment is around 60%, so there should be a compelling reason to attempt repair. Hope this helps. Dr Joseph

Ronald J. Edelson, MD · Answer

You are correct that septal perforations are difficult to repair. This is due to the lack of available tissue to close the hole. It sounds like your surgeon is experienced with repairing these and thinks your perforation can be successfully closed. Otherwise he or she wouldn’t even want to try. Most surgeons hate repairing these. Also your perforation is relatively small.

Matthew Bridges, MD, FACS · Answer

Septal perforation repair is a difficult surgery that should only be performed by expert nasal surgeons with specific training in this operation. A 5x3mm perforation should have a success rate of >90%.   It depends on the cause of the perforation, however.  I perform all these surgeries closed, which provides a much faster recovery.  Make sure you seek out an expert who has lots of experience with this operation.

Septal Perforation Repair : Why do the success rate differ from physician to physician?

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