Can a perforated septum heal itself?

Question

I have a perforated septum most likely from nose surgery a year ago to correct a deviated septum or from using a nasal steroid to treat allergies for the last four years. The perforation is 4 mm. My ENT gave me an antibiotic ointment and said that I had a "50/50" chance of the hole healing itself. But from what I have read a perforated septum requires surgery to heal. Can it heal itself?

Anil R. Shah, MD · Answer

Septal perforations typically can not heal themselves.  Septal perforations range in size and symptoms.  Typically, posterior septal perforations can be left alone that are asymptomatic while the more anterior the perforation the more likely it will become symptomatic.  If a perforation is stable in size (especially if the patients is using nasal saline, gel and other nasal emollient) then observation is fine.  If the perforation continues to grow in size or becomes symptomatic, repair can be considered.

Parker A. Velargo, MD, FACS · Answer

I'm sorry that you have this issue.  Perforations in the septum do not typically heal on their own.  Surgical correction is the best chance at fixing them.  Surgery would be indicated in your case if you had persistent bleeding, crusting, infection, bad odor, or persistent whistling.  Otherwise, it's best to try and live with it -- pay particular attention to good nasal hygiene including daily nasal saline and vaseline to the perforation to keep it moist.  Be sure you see a facial plastic surgeon or plastic surgeon for repair should you need to go that route.  I wish you well!

Joe Gryskiewicz, MD, FACS · Answer

Hi A Liberator,I am sorry you are having a problem.  The main thing to ask yourself is if it is causing you problems or symptoms.  Is it bleeding, crusting or whistling, or smells bad.  If so, then fix it, but your would need a super expert with a lot of experience to stack the cards in your favor.  Otherwise, just leave well enough alone.  It wouldn't heal a year postop.  I wish you all the best,"Dr. Joe"

Michael M. Omidi, MD, FACS · Answer

Perforated septum generally do not heal themselves.  You will need a surgery to correct it that can be somewhat complex.   However, not all perforations necessarily need to be corrected.  Best of luck. Dr. Michael OmidiAn in-person exam with a board-certified plastic surgeon is the best way to assess your needs and provide true medical advice.

Harsh B. Amin, MS, MCh · Answer

Perforations in the septum do not typically heal on their own.  Surgical correction is required only in symptomatic cases,not in all cases

Garrett H. Bennett, MD · Answer

The perforation will be there unless closed. If it whistles, bleeds, or crusts then you could consider fixing it. At 4mm most facial plastic surgeons should be able to close it. If there are no symptoms then you should leave it alone.

Brajendra Baser, MS, DNB, FRCS(Ed) · Answer

A through and through septal perforation of a years duration is unlikely to heal on itself, if asymptomatic it  can be left alone

Can a perforated septum heal itself?

Answers (7)

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