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Nasal Septal Perforation Repair

Conveniently located to serve St. Petersburg, FL and Tampa, FL

The nasal septum is the wall in the middle of the nose that separates the two nostrils and sides of the nose. The septum can develop a perforation, or a hole, in it from things like previous surgery, trauma, drug use, or autoimmune conditions. A septal perforation often causes symptoms such as:

  • Nasal congestion
  • Crusting
  • Whistling
  • External nasal collapse
  • Bleeding
  • Runny nose
  • Postnasal drip

Nasal Septal Perforation Repair

Nasal septal perforation surgery is quite complex and there are relatively few surgeons in the US that perform it well. Dr. Caceres performs his nasal septal perforation repair by rotating the nasal lining to close the hole from two different areas on each side of the nose. He also places a special graft between the two sides to improve healing.

Nasal septal perforation repair surgery success rates vary depending on the size and location of the hole. Dr. Caceres can often achieve perforation closure in over 95% of patients with a single surgery. Studies have shown that the average rate of septal perforation closure for surgeons not properly trained is less than 50%. Due to his high success rates, Dr. Caceres has repaired septal perforations in patients from all over the world and is frequently referred to patients from other facial plastic surgeons.

Surgery to repair a nasal septal perforation may be combined with other procedures such as rhinoplasty, revision rhinoplasty, revision septoplasty or turbinate reduction in order to achieve the best appearing and best functioning nose.

If you have a nasal septal perforation that bothers you, call us today to schedule a consultation with Dr. Caceres.

FAQs Septal Repair

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What Is a Septal Perforation?

A septal perforation is a hole that develops in the nasal septum, the cartilage, and the bone barrier that separates the two sides of the nasal cavity. This condition can cause various symptoms, including nasal congestion, nosebleeds, and crusting, and may lead to a decrease in the quality of life if left untreated.

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What Causes Septal Perforation?

Septal perforations can be caused by several factors, including certain medical conditions that affect the nasal lining, such as chronic infection, previous nasal surgeries (such as septoplasty), trauma to the nose, prolonged exposure to irritating chemicals, nasal decongestant sprays or illicit substances.

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Can Septal Perforation Repair Improve Symptoms Like Nasal Congestion and Nosebleeds?

Yes, successful septal perforation repair can significantly improve symptoms associated with the perforation, such as nasal congestion, nosebleeds, crusting, and whistling sounds during breathing. By restoring the integrity of the nasal septum, the surgery aims to improve nasal function and overall quality of life.

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Is Rhinoplasty Commonly Recommended alongside Septal Repair?

Yes, rhinoplasty is often recommended to accompany septal repair surgery. This is primarily to ensure minimal changes to the shape of the nose or to address any cosmetic concerns that the patient may have. Combining these procedures allows for comprehensive correction of both functional and aesthetic issues related to the nose.

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Can Successful Septal Repair be Difficult?

Yes, repairing a septal perforation can be challenging, so choosing a surgeon experienced in performing the procedure is essential, and even an experienced surgeon may not be able to achieve one hundred percent closure. The difficulty of septal perforation repair is influenced by:

Size of the Perforation– Larger perforations are more difficult to repair than smaller ones. As the size increases, so does the complexity of the surgery needed to close the gap.

Location of the Perforation– Perforations located in certain parts of the septum, especially those close to critical structures like the nasal valves, may be more challenging to repair because of the risk of altering nasal function.

Etiology of the Perforation– The cause of the septal perforation can also impact the difficulty of repair. For instance, perforations resulting from inflammatory diseases or cocaine use might be more challenging to treat due to compromised tissue health.

Patient’s Overall Health– The patient’s general health, including factors like blood circulation and the ability to heal, can affect the outcome. Conditions that impair healing, such as diabetes or immune disorders, or habits like smoking, can complicate the recovery process.

Previous Nasal Surgeries: Patients who have undergone previous nasal surgeries might present scar tissue, which can make additional surgeries more complex and affect the healing process.

Despite these challenges, advancements in surgical techniques and materials have improved the success rates of septal perforation repair. The use of local flaps, tissue grafts from the patient or bio-compatible materials, and improvements in surgical precision, particularly with the advent of endoscopic surgery, has made it possible to successfully repair perforations that would have been considered difficult or impossible to treat in the past.

However, it is important for patients to have realistic expectations and to understand that some perforations may not be completely closed or may require more than one surgical attempt. The goal of the surgery is not only to close the perforation but also to restore nasal function and alleviate symptoms associated with the perforation.

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What Are the Potential Risks and Complications of Septal Perforation Repair?

As with any surgical procedure, septal perforation repair carries risks. These may include bleeding, infection, perforation recurrence, alteration in the shape of the nose, decreased sense of smell, and, rarely, a change in the quality of the voice. It is important to discuss these potential risks with your surgeon before the procedure.

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What Is the Recovery Process Like After Septal Perforation Repair?

Recovery from septal perforation repair varies depending on the complexity of the surgery and the individual’s overall health. Typically, patients can expect some swelling, bruising, and discomfort in the initial days following surgery. Most people can return to work and light activities within a week or two, but full healing and results may take several months. Patients should diligently adhere to post-operative care instructions including the attendance of all scheduled follow-up visits to monitor healing and address any concerns.