Nasal Septal Perforation Repair

About this procedure

Our procedure for repair of septal perforation has become the standard of practice worldwide. A perforation of the nasal septum is a disturbing situation to patients. They experience whistling, crusting, intermittent nasal bleeding, improper nasal airflow, and uncontrollable foul odors occurring within their nose.

The most common causes of septal perforation include chronic nasal picking, cocaine drug abuse, exposure to breathing caustic chemicals, and prior nasal septal surgery.

Nasal septal cartilage depends on the pink colored, moist nasal lining, called mucosa, for its blood supply. Anything which reduces the blood supply—such as constriction of small blood vessels by cocaine or other chemicals—can cause the cartilage to die. When this happens, a hole occurs. If a surgeon fails to close corresponding rents in the nasal mucosa after corrective nasal septal surgery, and does not replace a cartilage matrix graft, the opening will enlarge, leading to a hole, or perforation, in the septum.

Repair of nasal septal perforation is available using highly specialized reconstructive techniques. A successful repair requires a three-layer closure, which includes bilateral, widely mobilized muco-perichondrial flaps, with an interposed collagen fibrous sheet (usually temporalis fascia). This method, which we initially reported in the 1970’s (Fairbanks & Fairbanks), is the basis for successful septal perforation repair today. Our procedure can provide a 90% success rate, as compared to a 30% success rate of other, less than adequate procedures.

If you have a symptomatic nasal septal perforation, and wish to undergo surgical repair, do not settle for a lesser operation, which may have little chance of success. Given the proper surgical procedure and appropriate post-operative care, you can anticipate a successful result, and return your nose to a more normal physiologic state. You can also expect the disagreeable symptoms you experience from your septal perforation to disappear.

Dr. Grant A. Fairbanks has extensive experience treating patients with nasal septal perforations of all causes. If you have a symptomatic nasal septal perforation, call our office and schedule an appointment for a consultation.