Perforated Septum; how worried should I be?

A small septal perforation should not lead to any functional or cosmetic problems.  However if it can be fixed with a chondromucosal flap, it may be something to consider.  

Septal perforations range in size and symptoms.  Typically, posterior septal perforations can be left alone that are asymptomatic while the more anterior the perforation the more likely it will become symptomatic.  If a perforation is stable in size (especially if the patients is using nasal saline, gel and other nasal emollient) then observation is fine.  If the perforation continues to grow in size or becomes symptomatic, repair can be considered.

Thank you for
your question. I am sorry to hear about the issues you are having. Many
patients will develop a septal perforation in their lifetime. Some are due to
trauma, some from disease and others occur from a nasal surgery. Fortunately
only some people will even notice the perforation. Symptoms can include
whistling, crusting or bleeding. If the patient has symptoms that bother them
there are treatments that can be tired including creams, saline irrigation or
septal button. Repair of the perforation is possible but not always easy.Please address
your concerns with your surgeon. Good luck and
hope this helps you.Dr. Wayne

Dear TiffanyIt depends on the size and location of the perforation. Generally small perforations are without symptoms and do not cause issues other than an occasional whistle sound on breathing. Larger perforations can lead to crusting and bleeding. Generally no need to do anything unless it keeps enlarging or you have any symptoms.

Small septal perforations can occur after septorhinoplasty.  They cause problems when they create turbulent airflow, which can make you feel "stuffy" even when you have wide open passages.  They can create a "whistling" sound when breathing, and can sometimes crust and bleed if they are not cared for.  Usually, small postoperative perforations do not cause these problems.  Generally, septal perforations are fixed to help correct the above problems, but they may be fixed as a preventative measure as well.  Do not worry excessively about the perforation, and make sure to visit with your surgeon for their advice.  

Thank you for you question.  A septal perforation is a rare post-operative issue that can happen after septorhinoplasty.  Usually these are small, and are of no consequence.  Be sure to follow up with your surgeon, though, so this can be followed.  Depending on the location of the perforation (if it is close to the front part of the septum), they could cause a breathing issue. Hopefully as your swelling goes down from surgery, you will be able to breathe better.  I hope that this helps, -David Gilpin