The nasal septum is a normal tissue that separates both the nostrils and septal perforation is a term used for a break or a gap in this nasal septum. This gap creates a direct communication between the two normally-separate sides of the nose.

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Incidence, age and sex

The exact incidence of nasal septum perforation is not known; however the nasal medical practitioners do come across with such patients. It can affect an individual at any age.

Signs and symptoms

An individual with nasal septum perforation may complain of whistling sound during breathing accompanied with nose bleeds. The bleeding from nose may become a recurrent feature and can either be spontaneous or caused by a specific incident. Bleeding can vary from mild to severe. There can be frequent crusting and dryness of the nasal passage. The affected individual may have a runny nose or severe nasal obstruction.

In most cases, the condition can be diagnosed on basis of symptoms, physical examination and meticulous inspection of the nasal mucosa by a health care provider. Specific blood test, urinalysis and in some cases CT scan, may be advised to rule out associated diseases such as tuberculosis or sarcoidosis. Rarely, biopsy of the septal tissue may be needed to detect fungal or bacterial infections or a tumour.

Causes and prevention

The perforation of nasal septum may occur due to several causes like habitual nose picking, blunt trauma to nose, previous septal surgery, cocaine abuse or over exposure to certain chemicals. Certain infectious diseases such as syphilis, tuberculosis, sarcoidosis may also contribute to this condition. A rare, autoimmune disorder namely Wegner’s granulomatosis may also cause perforation of nasal septum.

The nasal septal perforation can be prevented by removing the causative factors such as nose picking, cocaine snuffing, chemical exposure and minimizing the use of topical nasal decongestant. Using a humidifier in a room helps to prevent dryness and formation of crust. Patients suffering from any kind of respiratory tract disease should be treated adequately and timely.

Complications

The complications of nasal septal perforation include nasal congestion, nasal drainage and recurrent nose bleeds.

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