Septal Perforation - Medical Aspects Treatment & Management

Updated: Jul 20, 2022
  • Author: Rami K Batniji, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
  • Print

Medical Care

Although several surgical options are available for the treatment of septal perforations, this article focuses on the nonsurgical management.

Abstinence from the causative agent is of utmost importance in the medical management of septal perforations if the patient has a history of drug abuse (such as cocaine use) or the use of nasal decongestants or nasal steroid sprays.

Perforations of the posterior septum are typically asymptomatic and, as such, rarely require treatment. However, intranasal crusting may be problematic for the patient, especially if the edges of the perforation are not well healed. These patients may benefit from medical treatments aimed at keeping the nose moist. These include the daily application of petroleum jelly on a cotton-tipped applicator to the inside of the nose, the application of a nasal emollient such as Ponaris oil, or nasal irrigations. In addition, a humidifier in the home may benefit the patient.

Perforations of the anterior septum may cause the sensation of nasal obstruction or result in a whistling sound upon nasal breathing. A silicone button prosthesis may relieve these symptoms. In the office, a silicone button prosthesis may be placed with the help of a local anesthetic.

In individuals who remain symptomatic despite the aforementioned nonsurgical treatments, surgical management may be of benefit (see Septal Perforation: Surgical Aspects).



If the cause of the nasal septal perforation is not clear, consider obtaining a consultation with a medical specialist or rheumatologist.