Nasal Septal Perforation Repair

About this procedure

Our procedure for repair of septal perforation, first reported in the 70s (David N. F. Fairbanks, M.D. and Grant R. Fairbanks, M.D.), has a 90% success rate or greater, whereas other procedures have a 30% success rate or less; therefore, our procedure has become the standard of practice worldwide.

A perforation of the nasal septum is a disturbing situation to patients. They experience whistling, crusting, intermittent nasal bleeding, improper nasal airflow, and uncontrollable foul odors occurring within their nose. The most common causes of septal perforation include chronic nasal picking, cocaine drug abuse, exposure to breathing caustic chemicals, and prior nasal septal surgery.

Nasal septal cartilage depends for its blood supply on the pink-colored, moist nasal lining, called mucosa. Anything which reduces the blood supply—such as the constriction of small blood vessels by cocaine or other chemicals—can cause the cartilage to die. When this happens, a hole occurs. If a surgeon fails to close corresponding rents in the nasal mucosa after corrective nasal septal surgery and does not replace a cartilage matrix graft, the opening will enlarge, leading to a hole, or perforation, in the septum.

Repair of nasal septal perforation is available using highly specialized reconstructive techniques. A successful repair requires a three-layer closure, which includes bilateral, widely mobilized muco-perichondrial flaps, with an interposed collagen fibrous sheet (usually temporalis fascia). We do not recommend the use of any foreign material in this repair. The use of the patient’s own tissue is essential to success. There are no ill effects from harvesting temporalis muscle fascia. This method is the basis for successful septal perforation repair today. There are a number of less-than-adequate procedures to correct this malady, which should be avoided.

If you have a symptomatic nasal septal perforation and wish to undergo surgical repair, do not settle for a lesser operation, which will have little chance of success. Given the proper surgical procedure and appropriate post-operative care, you can anticipate a successful result, and return your nose to a closer-to-normal physiologic state. You can also expect the disagreeable symptoms you experience from your septal perforation to disappear.

Your surgeons at Fairbanks Plastic Surgery have extensive experience treating patients with nasal septal perforations from all causes. If you have a nasal septal perforation, be sure to call Fairbanks Plastic Surgery at (801) 268-8838 and schedule an appointment for a consultation/examination.