Septal Perforation - Medical Aspects Medication

Updated: Jul 11, 2018
  • Author: Rami K Batniji, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Medication

Medication Summary

The medications used in the treatment of nasal septal perforations generally involve the topical application of agents that clean and humidify the nose or that alter the nasal mucosa.

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Topical decongestants

Class Summary

These agents are used to shrink nasal mucosa to allow better visualization, to allow easier insertion of nasogastric tubes with less trauma, and to provide temporary management of epistaxis.

Oxymetazoline 0.05% (Dristan, Allerest, Afrin)

Topical vasoconstrictor; decreases swelling and congestion in the nose.

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Topical hormones

Class Summary

These agents are used to induce trophic changes in nasal mucosa (thickening of thin, delicate nasal mucosa).

Conjugated estrogen (Premarin)

When mixed with nasal saline, can be applied topically to thicken nasal mucosa to decrease epistaxis; 25 mg of conjugated estrogen (Premarin Secule kit) mixed with 1 bottle of saline nasal spray; keep refrigerated and discard after 30 d; discuss with patient that this is an off-label use of the drug. Discuss risks and benefits of using this drug; only for use in patients with severe epistaxis due to the perforation.

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Topical antibiotics

Class Summary

These agents, when applied to nasal mucosa, can keep tissue moist. Drying of nasal mucosa can induce epistaxis.

Mupirocin (Bactroban cream)

Apply topically to nasal septal mucosa to keep nasal tissue moist.

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