Septal perforation FAQ

Yes. Crusting, dryness, picking and poorly fitted septal buttons enlarge perforations. The larger it gets, the more symptomatic and the harder to close. Not waiting is a real argument. Read more: Symptoms and measurement ›

No. It is a recognised complication, occurring in 0.5 to 3% of cases, and should have been part of the pre-operative information. You are entitled to your full medical records and, where applicable, to a complaint or compensation process. Read more: Perforation after septoplasty ›

Yes, in the great majority of cases, provided you choose a surgeon who closes them regularly. Expert centres publish over 90% closure, including for perforations larger than 2 cm; occasional ENTs report 40 to 79% depending on size. Read more: Real success rates ›

The 2026 international consensus reserves it for patients who cannot or do not want surgery, and advises against offering it first-line. It is a permanent foreign body: repeated infections, sometimes severe, and progressive enlargement of the perforation through rubbing are documented risks. If a button is indicated, prefer a custom 3D-printed model, ideally in two magnetic pieces. Read more : The septal button ›

Saline rinses morning and evening, moisturising gels and ointments (dexpanthenol, hyaluronic acid), oils (sesame), humidifier at 40% or more. Avoid picking, cotton buds, decongestants, steroid sprays aimed at the septum, and dry air. Place no foreign material in the nostril (cotton, packing, prostheses): it lodges in the perforation or damages its edges. Read more: Daily care ›

If possible, yes, with your doctor. Steroid sprays are among the recognised causes of perforation, especially when the jet hits the septum day after day, and the risk seems highest in the first year: with a perforation, it is best to do without. Your doctor can stop or replace it; if it remains essential (severe allergy, polyps), they will correct the technique: head tilted slightly forward, bottle held in the hand opposite the nostril, tip aimed towards the outer corner of the eye, no hard sniffing. Decongestant sprays (vasoconstrictors) are best avoided altogether when you have a perforation: they constrict the blood vessels of the septum, and prolonged use is associated with perforation. Read more: Nasal sprays and perforation ›

Ask about annual perforation volume, closure rate at 12 months for your size, the technique and where the mucosa comes from, splint duration, and what happens if it fails. Most ENTs, even good ones, do one a year or fewer: go to a centre that closes dozens. Read more: Specialist surgeons ›

Within the EU, EEA and Switzerland, yes, through the S2 authorisation requested before travelling, in a public hospital. UK residents in England can apply through the NHS S2 route under strict criteria. Outside the EU (Turkey, USA) there is no cover: patients report about $5,000–6,000 in Istanbul and €26,000–36,000 in the United States. Read more: Practical and legal ›

Usually one hospital night, silicone splints for 2 weeks to 2 months depending on the team, rinses several times a day, no flying for 1 to 2 weeks. The result is judged when the splints come out, then at 6 and 12 months. Read more: After the operation ›

Not always, especially if the turbinates have been reduced (empty nose). But a 2026 prospective study shows improved smell, mucociliary clearance and quality of life after closure. Read more: Real success rates ›

No. The leading cause is nasal surgery. Cocaine is one cause among eight categories. People whose perforation does come from drug use deserve the same care, without judgement, with support to stop. Read more: Definition and causes ›

The international consensus uses: small under 1 cm, medium 1 to 2 cm, large 2 to 3 cm, subtotal beyond 3 cm. A vertical height of 1.5 cm or more also counts as large. Only endoscopy and a CT scan give a reliable measurement: insist on dimensions in the report. Read more: Symptoms and measurement ›

Whistling comes from air passing through a small perforation. It often disappears as the perforation enlarges, which is not good news. According to the consensus it is one of the signs that justify offering surgery upfront. Read more: Whistling nose ›

Nasal endoscopy, ideally recorded, and a sinus CT scan. Blood tests (serology, autoimmune work-up) if the cause is not obvious. Biopsy is not routine; smell tests only if you report a loss of smell. Read more: Care pathway ›

Yes, but cabin air is very dry: moisturise before and during the flight (gel, isotonic spray, oil) and avoid picking. After surgery, most teams ask you to wait 1 to 2 weeks. Read more: After the operation ›

Opinions differ. Many surgeons prefer to close the perforation first, then reassess empty-nose symptoms months later; others treat both together. If your turbinates have already been reduced, have that history noted in your file and ask the surgeon which technique they propose in this context, as some harvest from the turbinates or the inferior meatus. Read more: Closure techniques ›

Ask for a written measurement, information about your options and a referral to a high-volume centre. You can also contact one of the surgeons in the directory directly, at home or abroad. Read more: Care pathway ›

In public hospitals within the EU it is covered by national insurance, and across borders via the S2 route. Outside the EU, patients report $5,000–6,000 in Istanbul and €26,000–36,000 in the United States, before travel and accommodation. Read more: Practical and legal ›