A Comprehensive Review


Nasal septal perforations, characterised by holes or openings in the nasal septum, can arise from a variety of causes, including trauma, chronic inflammation, and medical conditions. While some perforations are small and asymptomatic, others can lead to a range of complications if left untreated. In this article, we delve into the potential complications that can arise from untreated nasal septal perforations, emphasising the importance of early intervention and comprehensive care.

Understanding Nasal Septal Perforations

The nasal septum, composed of cartilage and bone, divides the nostrils and supports the structure of the nose. Perforations in this delicate structure can occur for various reasons, including trauma, infection, and underlying health conditions. When left untreated, nasal septal perforations can give rise to a host of complications that affect both function and quality of life.

Complications of Untreated Nasal Septal Perforations

  • Epistaxis (Nosebleeds):Untreated septal perforations can lead to chronic nosebleeds, known as epistaxis. The exposed blood vessels in the septum are more prone to damage, resulting in frequent and sometimes severe bleeding episodes.
  • Whistling Sounds During Breathing :Larger perforations can alter airflow through the nasal passages, leading to the production of whistling or hissing sounds during breathing. This can cause embarrassment and discomfort for individuals.
  • Impaired Nasal Function: As air passes through the perforation instead of the usual nasal pathways, normal airflow is disrupted. This can lead to compromised nasal breathing, congestion, and difficulty in regulating temperature and humidity.
  • Nasal Crusting and Dryness:The exposed tissues of a perforation are more prone to drying and crusting due to reduced protective mechanisms. This can result in discomfort, pain, and even the formation of scabs.
  • Recurrent Sinus Infections:Nasal septal perforations can create a gateway for bacteria and pathogens to enter the sinuses, increasing the risk of recurrent sinus infections.
  • Cartilage and Structural Damage:Over time, untreated perforations can weaken surrounding nasal tissues, including the cartilage supporting the nasal bridge. This can lead to nasal collapse and deformities, altering facial aesthetics.
  • Aesthetic Concerns:Visible perforations can impact the appearance of the nose, potentially causing self-esteem issues and affecting one’s confidence.
  • Chronic Discomfort:Individuals with untreated perforations often experience ongoing discomfort, including irritation, pain, and sensations of dryness.
  • Risk of Infection: The exposed tissues of a perforation are more susceptible to infections, which can lead to local inflammation and complications if not addressed.

Prevention and Management

The potential complications of untreated nasal septal perforations highlight the importance of proactive care and timely intervention. Early diagnosis and treatment can help prevent the progression of these complications and improve overall quality of life.

Treatment Options

  • Conservative Management: Smaller perforations may be managed with conservative measures such as saline nasal sprays, moisturising ointments, and avoiding irritants.
  • Surgical Repair: Surgical intervention is often recommended for larger or symptomatic perforations. Techniques range from basic closure with local tissue to more advanced procedures involving grafts.
  • Septal Buttons and Prostheses: Temporary septal buttons or prostheses can be used to provide relief from symptoms while the patient decides on a more permanent solution.


Understanding the potential complications of untreated nasal septal perforations underscores the significance of seeking timely medical attention. From impaired nasal function and recurrent infections to structural damage and aesthetic concerns, these complications can significantly impact one’s well-being. By embracing a proactive approach to nasal health, individuals can address perforations early, explore appropriate treatment options, and prevent the progression of complications. Whether through conservative measures or surgical interventions, the goal is to restore optimal nasal function, alleviate discomfort, and enhance the overall quality of life.

Secure Your Appointment with Mr. Hassan

Request your appointment, whether virtual or in-person, by completing the form below. 

Our team will reach out to you within 48 hours to arrange a suitable date.

Please fill in all required fields.

Note: In case of an emergency, do not use this form. Instead, seek immediate medical assistance.