What should I do about 0.5 inch septal perforation?

Question

Got a septoplasty/turbinate reduction and now I have a 0.5 inch hole in my septum (septal perforation). What should I do? I am certain there was not a gaping hole in my septum before surgery. When I got my stints out after 2 weeks, I went to rinse and immediately realized saline was flowing right out the other nostril. I asked my wife to look and she literally gasped and said I have a huge hole. It measures about 1/2" by up to 3/4" the other direction. My surgeon was well reviewed but I can't believe he didn't mention this. It's only been 5 days now and so far I have not had any adverse effects.

Callum Faris, MD · Answer

Thanks for the question.
It is unfortunate that you have a perforation following surgery. 
Only symptomatic repairs need closure. I would suggest Neil Med sinus rinse 2-3 times a day and sniffing up Vaseline to lubricate the nose. If, this settle your symptoms then I would suggest you could avoid surgery. If however you have crusting, bleeding, sensation of blockage, noisy breathing it would be worth considering closure. A 0.5 cm perforation is amenable to closure with high success rates. I would delay the repair for at least 1 year following. If the perforation is asymptomatic I would get regular review (yearly) to check the perforation is not enlarging which can occur in some perforations. If, it was enlarging I would recommend closure before the perforation increases so much to make closure difficult. I hope this helps.
Dr Callum Faris

Jeffrey Joseph, MD, FACS · Answer

Septal perforations are a known complication of septal surgery, and in some very deviated septum’s are difficult to avoid.  Only if it results in symptoms, such as crusting, bleeding, saddle nose deformity, or persistent whistling, do they need to be repaired.

J. Charles Finn, MD · Answer

Septal perforation is a known complication of septoplasty, sometimes with the best of surgeons.  Perforations are more common in smokers, nose pickers and cocaine users. If a perforation is without symptoms, no treatment is necessary. If there is crusting, whistling or obstruction, repair is indicated. You will probably need to wait a year from your last surgery before repair.  See a rhinoplasty expert with experience in septal perforation repair. Good luck!

What should I do about 0.5 inch septal perforation?

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What should I do about 0.5 inch septal perforation?

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