| ID | 291 |
|---|---|
| Name | PERFORATION OF THE SEPTUM |
| Cause | Perforations can occur due to complications in surgery, aggressive cautery for recurrent nosebleeds, nasal trauma or fracture, infection, or from certain autoimmune diseases |
| Signs Symptoms | Nasal obstruction, whistling, epistaxis, crusting, pain, rhinorrhea, chronic rhinosinusitis, or foul smel |
| Diagnosis | Septal perforation is diagnosed by an endoscopic examination of nasal cavity. In some cases, additional testing such as blood work or a biopsy of the perforation may be needed to rule out causes. Small to medium sized perforations can be surgically repaired, while larger ones are more difficult |
| Investigations | Septal perforation is diagnosed by an endoscopic examination of nasal cavity. In some cases, additional testing such as blood work or a biopsy of the perforation may be needed to rule out causes. Small to medium sized perforations can be surgically repaired, while larger ones are more difficult |
| Management | Management: In asymptomatic cases, no treatment is necessary. Alkaline douching often helps in lessening the crusts. Some bland ointment is applied locally to keep the area moist. Operation is not very satisfactory. |
| Introduction | |
| History | |
| Etiology | 1. Traumatic. 2. Crusting ulcer. 3. Delayed drainage of abscess. 4. Idiopathic. 5. Misc- lupus, syphillis, malignancy. |
| Clinical Features | 1. The disease may be completely asymptomatic & found accidentally. 2. Crusting & irritation in the anterior part of the nasal septum. Epistaxis occurs off & on due to separation of crusts. 3. Whistleing noise is present sometimes. |
| Preventions | Prevention of nasal septal perforations is directed at removing or minimizing stressors known to irritate the nasal septum. These preventive measures need to be tailored to the individual patient. Stop cocaine use |
| Treatment | For septal ulcers, mupirocin ointment reduces the crusting, as may saline nasal spray. Doctors can sometimes surgically repair septal perforations using a person's own tissue from another part of the nose or with an artificial membrane made of a soft, pliable plastic |
| Complications | Septal perforations alter nasal airflow, creating turbulence which causes mucosal dryness which can predispose to crusting and epistaxis. Disturbance in laminar airflow can also cause subjective nasal obstruction or audible whistling noticeable during rest, sleep, or exercise |
| Prognosis | |
| Types | |
| Classification | |
| Observation | |
| Pathology | Septal perforation occurs most commonly along the anterior cartilaginous septum. Symptoms can include nasal obstruction, whistling, epistaxis, crusting, pain, rhinorrhea, chronic rhinosinusitis, or foul smell |
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