A nasal septal perforation is a hole in three distinct layers of the septum that is composed of the right and left mucoperichondrial flaps and the intervening cartilage/bone. Small septal perforations are often asymptomatic. However, anteriorly-located and larger perforations can create turbulent airflow that disrupts localized heat and moisture exchange to dry out the nose, reduce the sense of smell, and cause a sensation of obstruction in the absence of physical obstruction.
Surgical repair of septal perforations can be tedious and challenging and requires operating within the narrow confines of the nasal cavity without inadvertently enlarged the perforation further. Therefore, this is a surgery that many surgeons chose to avoid.
We prefer to repair septal perforations using an open rhinoplasty approach to maximize visualization. We advance mucosal flaps from within the nasal passages to repair the defect. We further reinforce the perforation repair by placing a connective tissue graft in between the repair sites. In certain cases, a reconstructive rhinoplasty can be performed in the same setting.
If you suspect that you may have a septal perforation or if you have one and you would like to know if you are a good candidate for surgical repair of the perforation, call to schedule a consultation with Dr. Delaney.