Managing Large Septal Perforations

Large septal perforations, typically exceeding 2 cm in size, present distinctive challenges that often mandate surgical intervention. This article is designed to unravel the intricacies of managing large septal perforations, emphasizing the critical role of timely surgical repair in addressing structural damage and achieving lasting relief.

Surgical Repair Requirement

  • Extensive Structural Damage: Septal perforations of this magnitude demand surgical repair, surpassing the suitability of septal buttons. The structural damage is too extensive to be effectively managed through conservative measures, necessitating a more comprehensive approach.

Video (1): Mr Hassan’s Surgical Approach.

The Expert's Recommendation

  • Temporary Symptom Relief with Septal Buttons: Mr. Hassan, a distinguished septal perforation specialist, advises the use of septal buttons as a temporary measure for symptom relief, irrespective of the perforation’s size. Drawing from his extensive experience, he notes that patients often struggle to tolerate septal buttons for extended periods due to complications like mucus build-up, implant rotation, and uncontrolled movement inside the nose.

Image (1): Septal Button.

  • Achieving Long-term Success: To attain the best long-term outcomes, Mr. Hassan strongly advocates for permanent surgical repair. This approach not only effectively alleviates symptoms but also closes the perforation and stabilizes the nose. With a remarkable success rate exceeding 99%, permanent surgical repair stands as the preferred choice for addressing large septal perforations.

Image (2): Surgery.

The Surgical Repair Process

  • Thorough Evaluation: The first step involves a thorough evaluation of the perforation’s size, location, and surrounding structures. This assessment guides the planning process for the surgical repair.

  • Precision Repair: Surgical repair typically involves the meticulous placement of tissue grafts from the nasal septum or other areas of the body. This precise approach ensures optimal closure with minimal postoperative discomfort.

  • Ensuring Successful Healing: Postoperative care is critical for successful healing. Patients receive comprehensive guidance on managing recovery, including strategies to minimize discomfort and expedite the healing process.


In conclusion, managing large septal perforations necessitates a nuanced approach, and surgical repair, particularly advocated by Mr. Hassan, emerges as the cornerstone for achieving lasting relief. For those grappling with large septal perforations, timely intervention and a personalized surgical strategy can pave the way for restored nasal health and improved overall well-being. For more in-depth insights and detailed information, please consult with Mr. Hassan, an expert in septal perforation care.

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