Septal Perforation Repair in New York, NY

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What is a septal perforation?

The nasal septum is a wall that splits the nose into two nasal cavities located behind each nostril. The nasal septal wall allows for streamlined airflow from the nostrils into the throat. A nasal septal perforation occurs when a hole develops in this septal wall, creating one unified cavity. Streamlined airflow is interrupted and chaotic, causing symptoms of nasal dryness, inflammation, infection, bleeding, and crusting. Lee Ann M. Klausner, M.D. is an experienced surgeon in septal perforation repair with a very high success rate in closing septal perforations. As a nasal septal perforation repair specialist, she has the experience and knowledge to treat you at the Klausner Institute in New York, NY.

What are symptoms of a septal perforation?

Symptoms of septal perforation can be very debilitating. The nasal septum normally is a solid wall that divides the nose into two cavities. Normally, this wall allows for streamlined airflow through the nose into the throat to reach the lungs. When there is a hole in the nasal septum (a septal perforation), airflow into the nose is disrupted. When the normal nasal airflow is disrupted, symptoms of nasal obstruction, chronic nasal dryness, nasal and sinus soreness, chronic nasal and sinus infection, frequent nasal bleeding, nasal crusting, and even whistling can occur. Some patient’s chronic infections that originate at the site of septal perforation extend to affect the sinuses and in severe cases can lead to bronchitis and pneumonia. Patients tend to deal with these symptoms on a daily basis, which has a negative impact on their quality of life. Even the quality of an individual’s sleep can be harmed by the nasal obstruction caused by a septal perforation.

What causes a septal perforation?

Septal perforation may be associated with events, such as complications from emergency medical or surgical procedures, a complication of routine deviated septum surgery, and nasal trauma. However, it is also linked to the abuse of recreational drugs that are inhaled through the nostril, most notably cocaine. Septal perforations can be caused by chronic nasal picking and chronic use of over-the-counter nasal decongestants, such as oxymetazoline/phenylephrine (Afrin®/ Neo-sinephrine®). Cocaine and these topical over-the-counter nasal decongestants cause chronic constriction of the blood vessels nourishing the septal membranes and cause the membranes to die from lack of oxygen to the tissues. Some septal perforations are associated with underlying autoimmune conditions. Septal perforations can become larger over time due to continued picking to remove septal crusting and recurrent bleeding. If the septal perforation becomes too large, it can cause worsening of symptoms and collapse of the nasal bridge/nose called a saddle nose deformity. Perforation repair is indicated in patients who have symptoms and who may be at risk of nasal collapse.

What does a septal perforation repair entail?

The process of perforation repair depends on the size of the perforation and on its location. The septal perforation is a hole in three layers: mucosal membrane on the right and left side of the septum, and cartilage and bone in between the membranes; therefore, repair to close the perforation must be done in three layers as well. This is a complex and technically challenging operation that must be done by an experienced facial plastic surgeon with specific training in septal perforation repair. Successful septal perforation repair is best accomplished by an open operation in which the septum is seen directly and the mucosal membranes above and below the perforation on both the right and left side of the septum are carefully elevated and advanced over the hole to cover it. A graft, such as Alloderm®, can be placed between the advanced membranes to support the repair and allow it to heal.

The success of a perforation repair mainly depends on a technically sound operation, protection of that repair after surgery, and good post-operative blood flow to help the repair heal. A successful outcome is not fully realized until several months after surgery when it is clear that the closure has remained intact. Factors that can cause the failure of a septal perforation repair in the post-operative period include smoking, exposure to second-hand smoke, inadequately treated diabetes, cocaine use, picking, and the use of topical nasal decongestants and topical nasal steroids.

Dr. Klausner guides her patient’s before and after surgery in order to help yield the best outcome for her patients.

How Can I Find Out More About Septum Repair?

Lee Ann M. Klausner, M.D. can recommend the optimal treatment plan for your nasal septum perforation. As a top-rated nasal surgeon, Dr. Klausner knows the ins and outs of performing this procedure with skill and care to ensure minimal complications. Schedule your visit to the Klausner Institute in Upper East Side, Manhattan, New York, NY, and see how Dr. Klausner can make a difference in your respiratory care.

Septal perforation repair FAQs

How is a perforated septum diagnosed?

It can be difficult to tell if you have a deviated septum, perforated septum, or similar issue on your own. That's why we recommend seeing an experienced specialist like Dr. Klausner as soon as you notice any of the above symptoms. Our clinic offers advanced in-office tools to diagnose your condition and create a personalized treatment plan moving forward.

Can a perforated septum heal on its own?

It depends on the size and location of the perforation, but it's very unlikely your issue will heal without surgery. An untreated perforated septum may continue to get worse over time and impact your quality of life. Patients will have continued obstruction when breathing, chronic dryness, sinus infections, and bleeding.

What is the difference between a deviated and perforated septum?

Both a deviated septum can cause symptoms, but they are treated differently. A deviated septum means the septum is crooked, while a perforation is a tear or hole in the septum wall. Both conditions can make it challenging to breathe, but it's still important to seek help from a professional in New York.

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