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Conditions

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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I was just diagnosed with a perforated septum. i picked my nose when I could not otherwise reomove what was blocking my paassages..almost everyday. It is weird to admit but that is what I did.my dr.said there is nothing that can be done, I will live a long an dhealthy life, the whistle will come and go, and there does not seem to be any other purpose accroding to him for the septum, accept for the whistle. So t is a pain. Itis not lfe threatening and your nose will not cave in, and no one can see it and in the big picture, I think we could do worse. I am going to go with this!





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Exactly what my Dr said Susan! Had a large perforation for years..don't worry at all... plenty of people with life threatening situations so this is not a biggie at all ..

My perforation is tiny but it causes dry crusting. I have seen four ENT consultants and one of them is a specialist. He also said that mine was so small that it isn't worth repairing and yet I feel as though it is making me feel ill. However, the anxiety and stress that can come with this is also likely to cause nose symptoms and I am stressed about mine.

Has anyone had their septal hole repaired? If so who is the best surgeon in the UK? Most experts are in the US but I cannot find a surgeon here who fixes holes like they do in the states.





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Does anyone have any solutions so far for the perforated septum? I have two holes in my septum because of picking dry blood. I don't really have any problems with it during the day, but at night when I sleep it start to whistle, that drive me mad. I can't get a good night sleep because of it. My mouth is constantly dry during the night because I breath through my mouth. I was thinking about this silicone buttons, does anyone tried that. and how is it working. I know I should just go and see a ENT, but I dread any operations.





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before go sleep I make small wet ball out of toilet paper and press it in nasal perforation from both side by fingers. In morning I removing it.

Thanks Sly, I used to put a small piece of wet cotton in my nose, not in the perforation though, but the cotton got dry, and it just didn't work for me. I will try the toiletpaper, at least it won't whistle :)

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Ive got to see the ent dr on the 29th of this month. My dr said i need to have a biopsy taken and will need surgery to close the hole in my nose. I'm really nervous. How long will i be in hospital for ? Will i have black eyes after the ip i'm worryin myself sick about it all.





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I've had a septal hole since I was 17, and am now 50. Septal stoppals were tried but were never successful. Lots of nose bleeds over the years. Unfortunately it's so uncomfortable I can't leave it alone. Now I'm worried as I have severe throbbing in the inside of my nose, and my glasses feel sore on the bridge of my nose. Have had a lot of sinusitis which is very painful, but more recently some pressure in back of neck, top of head and what appears to be mid-brain pressure/sensations. I'm actually very scared but drs just don't appear to be interested. Any suggestions?





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I would wonder if the pain you're having isn't sinus pressure related. Don't believe it's related to your spectacular perforation.I have the hole from picking at dry crusts. Embarrassing but true. If you were not a picker, you might have an ENT doctor or internal medicine doc check you for an autoimmune problem.

Im setting up an appointment with my dr to find out what can be done about the hole in my nose. Iv had nose problems for 5 yrs and now a hole in the cartlidge dividing my nostrils has developed. Are there certain questions I need to b asking my dr?





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see my post and reply below I cover several things to get you started thinking about this...

Don't get a nose button please don't do it you Will regret it the rest of your life

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I also consistently pick my nose and I have dried blood on the cartilage most of the time due to my constant picking. I can feel that my cartilage is getting thinner and can't stop picking my nose. This is embarrassing for me and I don't really talk about it. However; I am really beginning to worry about my strange addiction and am looking for any advice I can't get. Thanks in advance.





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I'd suggest that you use a saline solution rinse to keep your nasal passages moist, also don't use your finger to pick your nose, blow it instead. I wish I knew about saline rinse before I started picking at the bloody scabs, I wouldn't have this hole now :(

You need to stop picking! This is how I got the hole in my nose. I picked the same scab for 5 years and one day, I picked it and I saw blood coming from both of my nostrils and started to whistle out of my nose. Now I have to deal with this hole the rest of my life. My doctor said there are surgeries, but are usually very unsuccessful. Pretty much you have to learn to live with it. Buy a NettiPot, or any nasal saline, and use that for a few days to see if your stabbing goes away.

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Has anyone has a biopsy done because of the perforation? Please share your experience





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Yes I had a biopsy taken. I still don't understand what the letter means but at least it was confirmed no issues with erosive diseases...

I had a biopsy because my ENT said the septal perforation could be related to an autoimmune problem but I didn't have that, based on biopsy results.

I had a biopsy because my ENT said the septal perforation could be related to an autoimmune problem but I didn't have that, based on biopsy results.

Earlier in the year I was diagnosed with a “huge” nasal septal perforation. I had a nasal septal button fitted that was 28mm diameter with a centre core of 6mm diameter, it was fitted complete at this size. I was told this is what is normally used but usually cut down to fit. I was also told due to not having much cartilage left at the base of my nose where nostril openings are, that it may not be successful. When I went for a follow up appointment I was sure the button had moved. The ENT doctor said it had and I thought he was going to adjust it but he rather just pulled it out. He went on to say nothing more can be done. I wonder if anyone could offer any advice on getting a solution, if anyone knows of any doctors or techniques available via the NHS within the UK that could help me? BACKGROUND: I have had continued problems with my nose for over 10 years, with repeated GP visits. Around 4.5 years ago, I was admitted to hospital with chest pains (centre and below left ribcage). I was diagnosed with Pneumonia and Pleuracy. After leaving hospital, I also developed shingles and continued to have the pain/ discomfort in centre of chest, got increased issues with reflux and had increasing problems breathing... I was finally diagnosed with Asthma in January of this year and appear to be responding to the symbicort medication but unfortunately the problems caused by the septal perforation aggravate my Asthma and make life quite miserable – after being relatively symptom free for a month, those issues are now more heightened and it has confirmed the perforation is the reason I feel continually weak and tired... If anyone can offer any help or advice I would appreciate. I am going back for second opinion but am hoping a specialist of nasal surgery or someone who has had similar issues but got them resolved may be able to comment? Thanks in advance





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I dont have any anwers but I wanted to say that now I dont feel alone. I didnt kno this is a common condition. Iv had my nose problems for 5yrs and recently developed a hole. Five years ago my nose started scabbing evertime I blew it. The scabs wouldnt blow out so I had to use my finger. So embarrassing. My dr said to use saline nose spray to keep it moist. Im wondering if the saline made my cartridge thin?

"So embarrassing. My dr said to use saline nose spray to keep it moist. Im wondering if the saline made my cartridge thin?" Get over the embarrassment and stop picking your nose with your finger (trauma is a common cause and finger picking is one of those)... a little embarrassment is a small price to pay to not end up in the situation I am in... Look up nasal septal perforation via google... lots of info... I am not sure about saline solution making worse? I used it for years after seeing an ENT 'specialist' I now have a "HUGE" hole but I also used to clean my nose with wet wipes... Tbh I do not remember having a septum, so don't know when this dates to for me and can't confirm issues with saline... Various Rhinitis nasal sprays can cause or contribute to a septal perforation... I am not sure with regards the "nasal douche" if it is to keep moist? as salt tends to draw out moisture? I though it was to fight infection? Whilst it is not a long term solution Naseptin has proved someway helpful, as it does also soften scabs and helps them to come out when blowing nose and also consequently helps reduce amount of force used in trying to dislodge, which has to be better... I think it also has antiseptic qualities... the first week I used it was amazing it cleared out all top of my nose, which I guess was sinuses and sinusitis as I have since learned... Dependant on size of hole it may be worth pursuing ENT to get checked if any medical reason for erosion and consideration of the fitting of a septal button... This should also help improve any symptoms you may have relating to the perforation. The button should also help with scab formation as it settles... My advice is to question as much as you feel necessary... Surprisingly after over 10 years of struggling the onus has been put on me by my gp this very day and apparently I should have found out more etc... So ask until you are satisfied and ask again to be sure... Research as much as you can and do not be bullied by a GP who has little or no knowledge or experience in the subject matter... Seems long winded and maybe over cautious but I have since had pneumonia, pleurisy, developed asthma and it severely restricted my life :( and is immiserating... so on that note please stop picking with finger as you are risking further problems that you would live to regret... If you can't find any help, I did find petroleum jelly and the vics version useful as they also soften inside nose scabs and "crusting" as the doctors call it. the vics can help give sense of easier breathing to at night... the ENT i saw said was ok although I get impression he wasn't as convinced with vics in nose... but no reason to not put under nostrils... and apply naseptin or vaseline carefully with a qtip internally... Think about how it affects you and discuss those with your doctor as reasons for a potential referal? Good luck!

Ive got a extra large nasal septal perforation. After years of not realising what the problem was and many doctors visits I finally had a septal button fitted earlier this year. I had the standard 28mm diameter button fitted, with an internal diameter of 6mm. Unfortunately it moved and was removed during my post op consultation. The consultant said it would not stay in place and nothing else can be done. Has anyone experienced this and do you have any advice? Has anyone had a made to measure septal button or knows anything about them? Does any one have any advice regarding any further treatment as this is making my life a misery? Do you know any useful websites or consultants that may offer further advice? Any help or advice will be gratefully received.





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It looks like no one else has asked this question, so please fill in the rest of your details below.





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