Perforation of the nasal septum may occur due to various reasons.
➣ Surgical post SMR.
➣ Nose picking.
➣ Repeated cautery.
- Malignant diseases:
➣ Malignant tumors.
➣ Granulomas (Wegner’s).
- Chronic infections:
➣ Industrial poisons like mercury and chromium.
➣ Cocaine addicts.
➣ Most common site: Chondro Vomerine junction.
- Stage I: Redness.
- Stage II: Congestion of the mucosa.
- Stage III: Irritation.
- Stage IV: Rhinorrhea.
a) More anterior the perforation, more the symptoms.
b) Larger the perforation more the symptoms. Symptoms:
- Whistling noise during inspiration.
- Atrophic changes.
- Treat the root cause if any.
- Apply cicatric cream to lesion.
- Avoid trauma.
- Improve general health.
- Alkaline nasal douches.
1.Flaps- Surgery aimed at correcting nasal septal perforations is based on two main principles: repairing the perforation using mucosal mucoperichondrial and/or mucoperiosteal flaps from the internal nasal cavity, and connective tissue autografts interposed between the mucosal flap. Buccal flap can also be used.
2. Silastic buttons– silicone prosthetic devices can be used in those patients presenting contra-indications for surgery.
a) Temporalis fascia.
b) Composite pinna graft.