Septum perforation and thinning.

Question

I have suffered from a nasal septal perforation for about a year. I have quit the picking, fierce blowing, and spays and have kept the area clean and moistened. Despite my best efforts, I feel like the hole is getting bigger and the surrounding area, especially at the base and tip of my nose is thinning- I can see blood vessels exposed. Is this a sign of thinning nasal mucosa? I'm scared my nose is deteriorating. The anxiety of this is affecting my daily life. I need an experts help.

Heather Lee, MD · Answer

There are certain conditions that can cause septal perforations and if not addressed can continue to cause changes in your nose. I would recommend seeing an ENT to evaluate your nose and septum.  I think you anxiety start to be relieved once you get an appropriate evaluation. Best of Luck

Anil R. Shah, MD · Answer

Hello, You might want to get your perforation repaired. 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

Septum perforation and thinning.

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Septum perforation and thinning.

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