Can small septum perforations heal/close back up on their own?

Hello,Thanks for your question. Tiny perforations may be able to spontaneously close but if they are over 1cm in size it would be unlikely. It is important that you take care of the inside of your nose. It must be humidified and all infection controlled. If the cause of the perforation was use of cocaine, then that must stop as well or you have zero chance of fixing the problem. All this being said, even if you are left with a tiny perforation, without other symptoms, there is nothing you really need to do. But if you want it to heal, you have to take care of it.Good luck,Dr. Shah

Hello,Septal perforation repair is one of the most difficult procedures to perform. 


I developed a procedure to repair large septal perforations utilizing a pericranial flap.  The use of this flap can help close larger perforations.  Here are some methods of closure of septal perforation based on size:
-Small (pinpoint)- not advised to fix small perforations, especially asymptomatic perforations that are stable.  These should be observed.  The risk of the procedure of increasing size after repair
-Medium perforations- The use of a variety of techniques can be employed such as sliding flaps (can only repair perforations reliably at 1.5 cm), turbinate flaps (smaller perforations), and endoscopic rotational flaps (less than 1.5 cm) can be utilized.
-Large perforations- The use of pericranial flaps (see above) and free flaps (requires ICU stay) are the only 2 options.  I have had great success utilizing pericranial technique (see video below) to repair septal perforations.

 Best,Anil Shah MD

It would be extraordinarily unlikely for a septal perforation to heal by itself, without surgical intervention.  Keep the septal perforation well lubricated with nasal lubricants, since if you do not-you may get some crusting and the possibility of having nose bleeds can be quite high.  Surgery to close septal perforations is technically a very difficult operation-so be sure to see a board certified Facial Plastic Surgeon, a rhinologist, or an otolaryngologist-who has vast experience dealing with septal perforations-to guarantee successful surgery.  Good luck to you and good luck with your mom !!!!