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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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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

i had a biopsy taken which has now .left me a hole in my nose i know nobody can see it but i do and i feel that i have been scared ,i also have a scab that forms and yes you have to break it away to releave the preasure i do get a lot of headaches now and i think it is all to do with this problem

I'm not too sure whats wrong with my nose, I have had two septaplasties to help me breath through my nose, however I cannot breath through my nose its constantly congested and my face feels strange like its bloated, I get really bad head aches over my left eye, Sometimes there so bad my eye closes and it runs, I have seen GP's about this but they dont know whats wrong, could you please help as because I breath through my mouth all the time it drys my mouth out all the time and is affecting my teeth and gums, thankyou.

Hi, I too have a very annoying hole in my nose which accured after i had an infection for months which obstructed my breathing so i picked to be able to breathe..! resulting in a hole:-( I've had surgery to close which failed and now happy when hole has scabbed over, but very very down when scab comes out and when i breathe it makes a whistle noise which is very embarrassing! Sick of it now :(

I have a hole in my nose too, it gets crusty and i cant stop picking at it, can this cause it to collapse? I have never touched cocaine in my life so i dont know how this has occured?

Hi, I have had a perforated septum for over 10 years, I'm now 40. I often have nose bleeds, but use Naseptin cream to help stop the bleeding over a short period. The hole is about 15mm in diameter. Is there an operation I could have to repair the hole?

i have a large perforated septum it has been there over a year now i have been to see 2 ent surgeons they both said the hole which is about the size of a 5 pence piece was too big to be operated on.it's now causing me alot of pain & depression it's making me gag every single day.theres a disgusting,rotten smell which over the past 3 days has made me physically sick!when the stuff does'nt come out the front of my nose then it goes down the back of my throat making me throw up please someone help me!when your in a room with a horrible smell you walk out of the room when it's stuck in your own nose theres no getting away from it this is really depressing me causing me to cry every single day please help me someone please!




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