I have a large septal perforation. Any suggestions?

Question

I have a large septal perforation that is causing me severe migraines, sinus inflammation and pressure, difficult breathing , vision is blurry and am all messed up from my equilibrium being off. i have a constant nasal drip yet I can't find one doctor who will help me or knows how to repair this. I have been to several doctors, surgeons who say that it cannot be fixed... so what can i do about this ..i just can't live this way.there has to be something that can be done , someone who can help me .

Anil R. Shah, MD · Answer

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

I have a large septal perforation. Any suggestions?

Answers (1)