Nasal Septum Perforation: Symptoms And Treatment

Cocaine users are at high risk for a nasal septum perforation. In the following we explain everything you need to know about this condition.

A perforation of the nasal septum can be asymptomatic, but the  risk of complications is high. Cocaine use can be a possible cause. On the other hand, certain surgical interventions, such as straightening the nasal septum, also increase their occurrence. Both causes are common.

A perforation of the nasal septum may require medical or surgical treatment. You can find more information about this in this article. We also explain possible treatments to you.

What is a nasal septum perforation?

The nose has a complex structure, which is essential for proper breathing. It has two cavities, the nostrils, which are responsible for filtering the air you breathe. This allows the air to reach the lungs cleaner, more humid and warmer. In short, this prevents infections or injuries.

The nostrils are separated from each other by the nasal septum. This consists of cartilage and bone. It divides the nose and forms the inner wall of the nostrils. This helps to direct the flow of air into the nasal passages.

A perforation of the nasal septum is essentially a hole. This connects the two nostrils with each other. The consequences are, depending on the size of the hole, more or less serious symptoms.

The causes of nasal septum perforation

The causes of a perforation of the nasal septum are very diverse. This is because the septum is a partially cartilaginous structure. This structure is sensitive to certain substances that damage its tissue.

For example, one of the most common causes is surgery on the nose area. In other words, a perforation can be a complication of a rhinoplasty. Most importantly, this can happen after the correction has been made to eliminate breathing problems. Correction of the nose is a surgical procedure. This changes the shape of the nose. In addition to aesthetic reasons, it is also made to improve breathing.

Furthermore, according to the MSD Manual, a perforation can also be the result of an infection or trauma. Likewise, constant nasal picking and septum piercings (those that go through the nasal septum) can cause nasal septum perforation.

Other causes of this problem

Another important cause is intranasal drug use. Most of the time the drug cocaine is associated with it. A study carried out at the Hospital de la Santa Creu i Sant Pau shows that drug use is currently one of the main causes of this disease.

Cocaine is a drug. It has a constricting effect on the blood vessels in the nose. As a result, the tissue of the nasal septum is not adequately supplied with blood. This damages the tissue. This can result in perforation.

But many drugs are also associated with this disease. Take some nasal corticosteroid sprays as an example. The situation is similar with oxygen therapy through a mask or glasses.

Finally, another cause is exposure to chemicals or toxins. This mostly occurs in people who work in the chemical industry or in factories.

Symptoms that a perforation of the nasal septum causes

The symptoms depend on size of the hole. The hole can be very small, less than half an inch in size. On the other hand, the hole can also be larger than one centimeter.

The most characteristic symptom of this condition is frequent nosebleeds. The medical term for nosebleeds is “epistaxis”. The bleeding can be very heavy and worrying. The reason for this is that the nose is well supplied with blood.

In some cases, the patient has rhinorrhea instead of nosebleeds. This is the medical term for a runny nose. In addition, scabs often form around the nostril. Scabs can make breathing difficult.

Also headaches or pain in the nose are themselves often. Another sign of a perforation of the nasal septum is wheezing. In this context, wheezing means that a wheezing sound occurs when you breathe. This is caused when you inhale and exhale. The air flows through the hole in the septum.

Perforation can also have aesthetic consequences. According to the Herediana Medical Journal, the saddle nose is a resulting malformation. A saddle nose is characterized by a depression in the bridge of the nose.

treatment

There are several ways to treat the disease. The choice of treatment will depend on the patient’s symptoms and the size of the hole. In many cases, conventional therapy is sufficient. For example, the doctor may ointment prescribe that of bacitracin or mupirocin exists. These ointments reduce the build-up of scabs in the area of ​​the hole.

The patient can also be prescribed saline solution. This can be used as a spray. Like the ointment, the saline solution helps reduce scabs and ulceration.

In some cases, surgery may be required. The doctor takes tissue from another part of the patient’s body. Alternatively, artificial membranes can also be used. This will seal the hole.

Other surgical alternatives

Doctors at the Hospital Clinic de Barcelona perform a different surgical treatment. They use a tissue flap for the operation. They take this from the fibrous tissue that surrounds the skull (a so-called pericranial flap ).

The first thing they do is make an incision in the scalp. There they remove tissue. Then they drill an opening through the frontal bone. The next step is to place the tissue over the nasal cavity. This will reshape the nasal septum and eliminate the hole.

The advantage of this technique is that it is painless and allows quick healing. In addition, it does not leave any scars. The only scar is on the back of the skull. It is covered by the scalp.

diagnosis

To diagnose a perforation of the nasal septum, it is important for the doctor to recognize the symptoms. He also has to examine the nasal cavity carefully. For this purpose, he can also resort to endoscopy to thoroughly examine the nostrils.

This involves inserting a small tube with a camera through the nostrils. Furthermore, this hose enables the use of tools. For example, scabs can also be removed at the same time. Doctors can also take tissue samples through this tube.

A study published in the Journal of Radiology explains that computed tomography is one of the most useful diagnostic tools. This technique is mainly used with cocaine users.

Perforations of the cutting wall of the nose are avoidable

In many cases, perforations can be avoided. This is because they are mostly caused by inhaling drugs or irritants.

Therefore, avoid these types of harmful habits whenever possible. Also, protect your nostrils, especially if you work in the chemical industry or a factory. In addition, you should always see your doctor if you have any of the symptoms described here.