Septal Perforation Repair(Restoring Nasal Health & Airflow)
Complex surgical reconstruction to close holes in the nasal septum, eliminating whistling, severe crusting, and chronic nosebleeds.
What is a Septal Perforation?
The nasal septum is the wall of cartilage and bone, covered by a delicate mucous membrane, that divides the left and right sides of your nose. A septal perforation is a hole through this entire structure.
When a hole is present, the smooth, laminar airflow of the nose becomes turbulent. This turbulence dries out the nasal lining, leading to massive, painful scabbing and crusting around the edges of the hole. When these crusts are blown out or dislodged, they often cause severe, recurrent nosebleeds (epistaxis). Depending on the size and location of the hole, patients may also experience a highly distracting "whistling" sound when they breathe, or a feeling of nasal obstruction despite having an open airway.
Closing a septal perforation is technically demanding because the mucosal tissue inside the nose is incredibly thin and fragile. Septal Perforation Repair requires rotating healthy adjacent tissue inside the nose to seal the defect without creating tension.
Common Causes of Perforations
Perforations result from anything that severely disrupts the blood supply to the delicate septal cartilage.
The Transformative Impact
- Eliminates Whistling: Restores silent, normal breathing, especially during sleep and exercise.
- Stops Bleeding & Crusting: Allows the nasal mucosa to remain moist and healthy, stopping the cycle of painful scabbing and epistaxis.
- Improves Nasal Airflow: Restores laminar airflow, curing the paradoxical sensation of nasal congestion caused by the hole.
- Ditches the Button: Provides a permanent biological fix, meaning patients no longer have to wear, clean, or replace uncomfortable silicone "septal buttons."
Surgical Precision & Technique
Closing a septal perforation requires a multi-layered approach. Because the tissue inside the nose is tight, simply pulling the hole shut will fail.
Dr. Jowett frequently utilizes bilateral mucosal advancement flaps. He carefully separates the thin mucosal lining from the floor of the nose and the underlying bone, allowing it to stretch upward and slide over the hole. In addition to moving the mucosal lining, he places a graft (such as fascia from the temple, or processed acellular dermis) sandwiched between the two flaps. This graft acts as a scaffold for the tissue to heal across, significantly increasing the success rate of closure.
Why Choose Revitalis?
Septal perforation repair is notorious for its high failure rate when performed by less experienced surgeons. The technical difficulty of operating in a dark, narrow corridor on tissue as thin as wet tissue paper cannot be overstated.
Dr. Nate Jowett approaches these repairs with the same microscopic discipline he applies to facial nerve surgery. He understands the complex hemodynamics (blood supply) of the inside of the nose, ensuring that the flaps he creates remain perfectly viable during the healing process to deliver a permanent, lasting closure.
Selected References
- Health Utility of Rhinectomy, Surgical Nasal Reconstruction, and Prosthetic Rehabilitation. Faris C, Heiser A, Quatela O, Jackson M, Tessler O, Jowett N, Lee LN. Laryngoscope. 2020 Jul; 130(7):1674-1679.