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Nasal Septal Perforation

Nasal septal perforation (Photo from Wellcome Trust)

When former Eastenders actress, Daniella Westbrook, was photographed at the British Soap Awards in 2000 with her septum eroded from excessive coke-snorting, she not only became the poster girl for the ravages of cocaine, but also brought nasal septal perforation into the limelight. The septum, composed of cartilage and thin bone, can develop a hole in the cartilage, not only through cocaine use, but also as a complication of previous nasal surgery, excessive nose picking, trauma, cancer, or diseases such as tuberculosis or syphilis. As damage reduces blood supply in the septum, the cartilage begins to die, and a hole develops. Many septal perforations don’t need to be closed, and small perforations may need only frequent rinsing with prescription saltwater solutions and applying lubricating gels. Septal ‘buttons’ can also be inserted to fit the hole, which can be an alternative to surgery. However, there are various surgical techniques available for larger perforations, which can be performed under general anesthesia.

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Laura, I would love to know how you got on with the doctor, if you've been. I've had the same problem as you for years, but doctors and ENT specialists have been less than helpful. My problem started because I was under a lot stress and I got an infection. The stress continued and I subsequently began to suffer from adrenal fatigue and sinusitis. Like you, I inadvertently made a hole in my nose while desperately trying to clear the airways. I have since been told I have rhinitis. I have now discovered that nasal infections and sinusitis (amongst other conditions) can cause perforated septums, although in my case I think the excessive picking was the cause. I have also discovered that perforated septums can cause rhinitis. One ENT specialist I saw diagnosed rhinitis but then prescribed beta blockers which I now know can also cause rhinitis!! I still have the hole which I'm desperate to fix particularly as I believe it will help cure my rhinitis. Have you made any progress?

Maria, did you have the surgery and are you happy with it? If so, can you let us know who the surgeon was?

I can't tell you all what a relief it is to hear other similar stories. Makes you realise you're not alone. This is a difficult subject as there is such a stigma attached to 'holes in septums' relating to drug-use and I think it's great we're raising awareness of other causes.

x

Maria,
What doctor did you see who has the experience in repairing septal perforations? Did you get the surgery? And are you glad you had it done? I'm thinking about it too.

I went to the doctor this morning as I have been having nose bleeds everyday this week. I was told I have a hole in my septum, which is usually caused through a physical trauma or through cocaine abuse. I have never taken any drugs and I cannot really think of any time i have been hit in the nose. I do tend to pick my nose when I am stressed or nervous. I gave a blood sample and I have been referred to ENT for an appointment. I have to say I am terrified something is wrong and have worked myself up into quite a state. Does anyone have any similar issues as I am very worried.

I too have been told i have hole in septum when i was referred to ENT for investigation for repeated ear infections. Like many with this problem are saying i experienced sores in the nose for weeks on end and pain across eyes and bridge of nose.Awaiting results.I do feel concerned as it was complete shock,especially to be asked if i pick my nose!I am 53.

Is there something that can be used rather than trimmer,because I've touched some of the very faint hairs with the trimmer that had started to make them to grow? So as for that So from now on I'd only use the trimmer for hairs in my nostrils.

I have a perforated septum now for about 10 years. My doc said to put some antibiotic ointment up there to protect. It works well when I remember. It get infected and I get headaches and feels like pain from inflamation runs down my naisal passage to lungs very painful.

Right, well mine all began 2 years ago when I was 20 years old. I got a sinus infection which made it quite difficult to breath and I blew away at my nose all day trying to clear it! Nothing worked so . . . Excuse the disgusting part, I picked it but only to make it worse because there was nothing to pick. Obviously my nasal passages were just inflamed which was blocking my airways. Anyway after all the picking i'd I had still not cleared my airways i'd only went and given myself another addition to the problem. . . . A scab on the inside which was blocking it even more at this point then i'd have to pick it as I couldn't stand the feeling having something in my nose. This vicious circle went on for 2 years. I'm now 22 and have a hole in my septem which I can fit my little finger through! I still get scabs 2 to 3 times per day and I still pick them but i'm going to the hospital next month to see if there's anything that can be done. I get really bad headaches and occasionally nasty smells. I only experienced whistling for about 3 days which i'm supposing I picked away at too often and made the hole big enough to reduce noise. I went to the doctor and he just laughed at me saying I had vibrating snot which was causing the whistle. I wasn't stupid I know I had a hole which was clearly infected that I found out at a later date but the headaches are unreal sometimes. I often feel light headed and dizzy like i'm going to pass out. Its always after removing the scabs. . . . I have tried to leave them but I loose patience when I struggle to breath especially at night when I fall asleep and my mouth automatically closes and I wake up feeling like i'm suffocating! Its awful thing to have however I still have a nose like a dog so my sense of smell hasn't been affected but my energy and moods have when the headaches attack. . Anyway wish me luck ppl hopefully the doc will fix it next month x

ive got a hole in my septum and when i squeeze it e white cheesy cream comes out

oh ps – should have said – dab a small amount of vaseline on each side of the nasal perforation every morning to act as a barrier. It is inflammation and irritation around the open perforation that may cause it to get bigger.

also wanted to ask Alison in regard to your
Post on 3 Jun 2009 23:00. I noted your surgery was not successful – can I ask where you had this done? Did you get an infection? Or could I ask what surgical option you where given. many thanks

I have a perforated septum. I went to 2 ENT NHS doctors who offered no assistance, no answers (only to say attempted closures had a poor success rate). I went for a private consultation – the consultant in question specialises in the area of closing septal nasal perforation (at a high price unfortunately); but albeit his success rate is high and he has performed what I would consider to be ALOT of surgical closure operations. The surgical procedure will last approx 2 and half hours. I am in the process of considering to proceed with surgery, its alot of money but if it gets rid of my headaches, the pain, the clicking – and making me miserable – its worth a shot. will keep you posted. M x





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