What can I do to close my small septal perforation?

Question

Dear doctors, I would like to know if it is possible to close a small septal perforation by 'cutting' on the edges of the hole in order to make it bleed and close the hole. I ask because my surgeon did something like this on the follow-up visit using a rotating tool on the hole. During this procedure I didn't feel any pain but I'm very skeptical since I haven't read anything like this anywhere. Thank you

Jacob Tower, MD · Answer

Hello, hope you are well. Septal perforations are notoriously difficult to close. In my practice, the method of closure is determined by the size of the hole. For very small perforations, it is possible to 'freshen the edges', elevate the mucosal lining, and close the perforation with various flap and suture techniques. Doing this in the office would be considered challenging by most. By contrast, larger perforations may need an open rhinoplasty approach to reconstruct the layers of the septum with an interposition graft to ensure the hole does not re-open. I also place protective silastic sheeting inside the nose to cover the wound while it heals. Depending on the technique, failure to close the perforation can sometimes worsen the problem by enlarging it. You also need to be very diligent with caring for the inside of the nose before, during, and after healing with emollients, etc.
Best,Dr. Tower

Michael S. Kluska, DO · Answer

Septal perforations are somewhat challenging to deal with and most often require some form of tissue flap to repair. The area is so sensitive that irritating the edges to encourage healing many times fails.

David M. Kowalczyk, MD, MBA, FACS · Answer

Hello! Septal perforations can be addressed with a button (not recommended) or a mucosal flap. Roughing the edges is not likely going to improve the area. It often needs a more robust closure to prevent the opening from enlarging.

What can I do to close my small septal perforation?

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What can I do to close my small septal perforation?

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