Large Internal Scabs 2 Years Post Septoplasty

Question

Had Septoplasty 2 years ago to correct a deviated septum in an attempt to help my sleep apnea. I did not pick my nose at all after the surgery for about a month and was using a nasal rinse for about 2 months. The problem is that my nose still develops large internal scabs every day or so, to the point that my breathing is actually worse then before the surgery. I am constantly picking my nose (in private) to rid the scabs. What should I do?

Paul E. Kelly, MD · Answer

Dear Swanster - I would agree with the previous comments that something is not quite right - scabbing 2 years post septoplasty suggests that either a chronic rhinitis or infection is present which may require a culture and an ointment like Bactroban or it may suggest a hole in the center divider or septum. Either way your nose should be evaluated by your local ENT/Facial Plastic Surgeon. Should you have a perforation, know that repair is very possible depending on the size of the hole - I encourage you to seek attention of a doctor who can perform this operation sooner rather than later so that repair is indeed successful - time only makes these perforations for the most part larger not better.

Gregory J. Vipond, MD, FRCSC · Answer

As previously-mentioned, it is not a normal finding to have severe crusting this far after an airway surgery for a deviated septum and large turbinate bones. You may have a perforation or hole in your septum. You may also have too much turbinate bone taken away. Ironically, with increased air flow through your nose, some patients develop a condition called atrophic rhinitis where this large amount of airflow does not become humidified by the nose and leads to dried mucous and crusting. This may be improved with the use of nasal saline spray, nasal saline gel, or vaseline inside each nostril 2-3 times a day. You should see your surgeon, ENT, facial plastic surgeon for evaluation.

Samir Shureih, MD · Answer

Consult an ENT for a complete exam of the septum. You may have a perforated septum.........................

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

It's unusual to have large scabs in your nose 2 years after septal surgery. You should see a Facial Plastic Surgeon and/or ENT to make sure you don't have any other pathology or a septal perforation.

Best,

Dr.S.

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