A hole in nose is medically referred to as a nasal septal perforation. This hole appears in the nasal septum, a portion of cartilage that separates the left and the right nasal airway passages. The symptoms can vary depending on the size of the perforation and other factors, but may include pain, runny nose, nosebleeds, and breathing issues.

How can someone get a hole in nose?

There are many causes to develop a nasal septal perforation. Medications and drug use can often compromise the blood flow to the nasal septum by causing constriction or tightening of the blood vessels in the nasal septum.

This causes decreased blood flow to the nasal septum, which causes tissue loss. Drugs such as cocaine or over the counter topical spray nasal decongestants can cause septal perforation if used over a long period of time.

Other causes include trauma to the nose, which may lead to a septal hematoma or abscess, that leads to perforation and loss of nasal septal cartilage. Chronic and compulsive nose picking can also lead to a hole in the septum. Additionally, prior surgeries, specifically nasal and sinus surgeries, can cause a perforation in the septum.

Can a septal perforation heal on its own?

It is very rare for a septal perforation to heal on its own. Typically the area needs to be reconstructed through surgery in order to correct the perforation.

Will a hole in the nose get bigger overtime?

It is not uncommon for nasal septal perforations to increase in size over time. Septal perforations cause turbulent airflow which leads to collection of crust and debris along the edges of the septal perforation. This crust can further erode the edges of the hole, making it grow larger over time.

What can be done to fix a hole in a nose?

A septal perforation, or a hole in the nasal septum, can cause a range of uncomfortable symptoms, including nasal dryness, crusting, bleeding, and difficulty breathing.

Treatment options vary based on the size and severity of the perforation, as well as the individual’s symptoms and lifestyle preferences. Here’s a detailed look at the available treatment methods:

1. Conservative Management

Conservative, non-surgical management is often the first line of treatment for smaller septal perforations or when symptoms are mild. The goal is to keep the nasal passages moist and reduce discomfort. This approach includes:

• Nasal Irrigations: Frequent use of saline nasal sprays or rinses can help clear debris, reduce crusting, and maintain moisture in the nasal passages.
• Nasal Emollients: Applying nasal moisturizers or emollients like petroleum jelly (Vaseline) can protect the mucous membranes and minimize irritation and crust formation.
• Air Humidifiers: Using a humidifier in living or sleeping areas can increase air moisture, preventing dryness that may worsen symptoms of a septal perforation.

While these measures can provide relief, they do not repair the perforation and may not fully alleviate symptoms. Conservative management is best suited for those seeking temporary or symptom-based relief.

2. Septal Button

For patients whose symptoms are not adequately managed by conservative methods, a septal button may be recommended. This is a non-surgical option that involves placing a prosthetic device inside the nose to physically close the perforation. Benefits and limitations include:

• Benefits:

  • Provides immediate relief by sealing the perforation and reducing airflow through the hole.
  • Can be an effective temporary solution for those who are not candidates for surgery or who prefer to avoid surgical intervention.

• Limitations:

  • Septal buttons may cause discomfort and require periodic replacement.
  • There is a risk of infection or irritation, and some patients may not tolerate the device well.
  • It is a mechanical solution that does not promote natural healing of the septum.

3. Surgical Repair

Surgical intervention is considered the definitive treatment for septal perforations, particularly for larger or more symptomatic holes that do not respond well to conservative treatments or septal buttons. Surgical options include:

• Endoscopic Repair:

  • Minimally invasive approach using a nasal endoscope.
  • Suitable for small to moderate perforations.
  • The surgeon uses tissue grafts, often harvested from the patient’s own nasal lining or from other areas like the ear or rib, to close the perforation.

• Open Septal Reconstruction:

  • This approach is used for larger perforations or when a previous endoscopic repair has failed.
  • Involves making an external incision and lifting the nasal skin to access the perforation.
  • Surgeons use tissue flaps and grafts to close the hole and may reinforce the septum with additional cartilage or bone grafts.

• Cartilage Grafting:

  • A graft, typically from the patient’s ear, rib, or septum, is used to fill in the perforation and restore structural integrity.
  • This method helps in rebuilding the nasal septum and provides long-term relief.

• Combination Techniques:

  • In some cases, a combination of techniques may be used, depending on the complexity of the perforation and the patient’s anatomy.
  • The goal is to ensure a robust repair, minimize scarring, and preserve or enhance nasal function.

Choosing the Right Treatment

The choice of treatment depends on multiple factors, including the size and location of the perforation, the severity of symptoms, patient preference, and overall health.

An evaluation by an ENT (ear, nose, and throat) specialist or a plastic surgeon with experience in nasal surgery is essential for developing a personalized treatment plan.

While conservative management and septal buttons offer temporary or non-surgical options, surgical repair provides the most effective long-term solution for restoring nasal function and comfort. Each patient’s needs and goals should be carefully considered when deciding on the best approach to manage or repair a nasal perforation.

View Before and After Photos of Septal Perforation Surgery on Instagram

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