Exploring Alternative Treatments

Effectively addressing septal perforations is vital to prevent potential long-term complications. The selected treatment approach is significantly influenced by the size of the perforation and the severity of accompanying symptoms. In this article, we delve into alternative treatments tailored to different perforation sizes to ensure a comprehensive understanding of available options.

Small Perforations (Less than 1 cm)

Management strategies for small perforations primarily focus on promoting mucosal health and preventing infections. This includes:

  • Increased Humidification: Initial management emphasizes augmented humidification to promote mucosal health.

  • Antibiotic Ointments: Application of antibiotic ointments to the affected area is crucial in preventing infections.

  • Nasal Irrigation: Regular nasal irrigation is recommended to keep the perforation clean and provide relief from symptoms.

Image (1): Measurement of the flap | Author: Hassan Elhassan | Image courtesy: Wikipedia.

Moderate Perforations (1-2 cm)

For moderate-sized perforations accompanied by severe symptoms, an initial intervention may involve a septal button implant. The septal button serves the following purposes:

  • Covering the Perforation: The septal button effectively covers the perforation.

  • Temporary or Permanent Placement: Depending on the patient’s tolerance, medical institutions may opt for temporary placement to stabilise the nose before considering permanent surgical repair.

  • Supporting Healing: The septal button supports the healing of the surrounding lining.

Image (2): Measurement 1 – 2 cm | Author: Mr. Hassan Elhassan | Image courtesy: Wikipedia.

Large Perforations (Over 2 cm)

Septal perforations exceeding 2cm generally necessitate surgical repair and are not suitable for septal buttons.

Image (3): Measurement Over 2 cm | Author: Mr. Hassan Elhassan | Image courtesy: Wikipedia.

The Expert's Recommendation

According to Mr. Hassan, a seasoned specialist in septal perforation treatment, septal buttons are recommended as a temporary solution irrespective of perforation size. Drawing from extensive experience, he notes that:

  • Mr. Hassan, an experienced septal perforation specialist, suggests using septal buttons as a temporary solution, regardless of perforation size..

  • In his extensive experience, most patients cannot tolerate septal buttons for an extended period due to issues like mucus build-up, implant rotation, and uncontrolled movement inside the nose, leading to chronic irritation.


For optimal long-term outcomes, Mr. Hassan strongly advocates for a permanent surgical repair. This approach not only alleviates symptoms but also ensures the closure of the perforation and stabilisation of the nose.

Mr. Hassan’s surgical method boasts an exceptional success rate exceeding 99%, providing patients with the opportunity to regain normal nasal function and overall well-being.

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