Home › ENT Conditions in Gangnam, Seoul

Nasal Septal Perforation Care in Gangnam, Seoul

Medically reviewed by Dr. Kim Yoo Suk, MD · Board-certified otolaryngologist · Former professor, Yonsei & Ajou University · Consultations in English

What is a septal perforation?

A nasal septal perforation is a full-thickness defect through the cartilage or bone of the septum and the lining on both sides. Most occur in the front cartilaginous part of the septum. Once the lining is lost on both sides, the underlying cartilage has no blood supply, so perforations rarely heal by themselves.

Symptoms

• Crusting inside the nose that keeps returning
• Recurrent nosebleeds from the edge of the hole
• A whistling sound when breathing through the nose, typical of small front perforations
• Paradoxical sensation of blockage due to turbulent airflow
• Dryness, discomfort or a bad smell
• Rarely, a sagging of the nasal bridge with large defects

Many small perforations are discovered by chance and cause no trouble.

Causes

• Previous nasal surgery, including septoplasty
• Trauma, including untreated septal hematoma after a nasal fracture
• Chronic nose picking and digital trauma to crusts
• Repeated cauterization for nosebleeds
• Long-term decongestant or poorly aimed steroid spray use
• Cocaine or other intranasal drug use
• Inflammatory and infectious diseases, such as granulomatosis with polyangiitis, sarcoidosis, tuberculosis or syphilis
• Rarely, tumors

How it is diagnosed at our Gangnam clinic

Dr. Kim examines the septum with nasal endoscopy to measure the size and position of the perforation and check the condition of its edges. When the cause is unclear, blood tests may be arranged to screen for inflammatory or infectious conditions, and a biopsy of the edge may be considered. A CT scan helps assess associated sinus disease or large defects. Identifying the cause matters because active disease must be controlled before any repair.

Treatment options

Conservative care

• Saline sprays and irrigation to soften crusts
• Petroleum-based or antibiotic ointment along the edge
• Humidifying the bedroom air
• Stopping any irritating sprays or substances

Many patients become comfortable with this alone.

Septal button

A soft silicone prosthesis can be placed in the nose to close the hole, reducing whistling, crusting and bleeding without surgery.

Surgical repair

Selected symptomatic perforations can be repaired using local mucosal flaps and graft tissue. Success depends on size, location and cause; larger or complex repairs may be referred to a specialized university hospital center. Repairs are carefully planned with you, and our surgery center explains how procedures are organized.

When to see an ENT

See an ENT if you have persistent crusting, nosebleeds or whistling, or if a doctor has noticed a hole in your septum. Seek prompt assessment for a rapidly enlarging perforation, a collapsing nasal bridge, or general symptoms such as fever, joint pain, cough or kidney problems, which may point to a systemic disease.

Seeing Dr. Kim in English

Dr. Kim Yoo Suk is a rhinology subspecialist who taught septal surgery as a professor at Yonsei and Ajou universities and has published on revision nasal surgery. He discusses sensitive causes confidentially and in English. Directions are on our location page.

Frequently asked questions

Will a septal perforation heal on its own?

Usually not. Because the cartilage loses its blood supply where the lining is missing on both sides, the hole tends to stay the same or slowly enlarge. Good moisturizing care prevents enlargement and controls symptoms in many people.

Does every septal perforation need surgery?

No. Small perforations without symptoms often need no treatment. Moisturizing care or a silicone septal button helps many symptomatic patients. Surgery is considered when symptoms persist and the cause has been controlled.

Can my previous nose surgery have caused this?

Septal surgery is one recognized cause of perforation, but there are many others, including trauma, nose picking and sprays. Dr. Kim will review your history and examine the septum to determine the likely cause and the best approach.

This page is general medical information written and reviewed by an ENT specialist. It is not a diagnosis. Symptoms differ between people — please see a doctor for an examination. In an emergency in Korea, call 119.