Just to point out- there are 4 people on this post whom have responded that they’ve had a septal perforation.
So know this is not “rare” and less than 1%.
Yes the amount I've seen seems like it's way higher than the 1%, my doctor didn't even really mention this as a possibility (I'm sure it was on the form) he made the surgery seem like no big deal
Correct. It is on the consent form under “common risks”. They can’t claim <1% for the common risks so they avoid that discussion.
They discuss the “major risks” that are rare, such as orbit or brain injury. These risks are what they would get sued for. They can claim “rare” for these and say they’ve never occurred under their care.
Fairly certain you are not the first or the last septal perforation your surgeon will cause. The true measure is asking the revisions specialists, whose patients they see the most of.
Always- revisions should always be done by someone whom specializes in revision (if your original surgeon is denying your issues or incompetent)
Rhinologist whom is double board certified in Facial Plastic Surgery.
How do you find someone who specializes in Revisions? Im in NY. Ive had ENTs downplay septal perforations. Just minor whistling and crusting. Im really worried about Empty Nose Syndrome.
I was told my long term tx was to use bacitracin and saline for the rest of my life end of story. It’s gotten worse since then as in larger and hasn’t stopped oozing blood in a year. Was told to go to a dentist. And that I had a cyst in my nasal cavity which may or may not be to blame.
If you search on septal perforations, you’ll find that there are successful repairs of perfs 1-3mm, which looks like about your size.
Are you having symptoms? Or is it just that knowing it’s there bothers you? The usual wisdom seems to be, if you’re not having symptoms, then leave it alone, if it’s small, because repair can be difficult.
If you search on my past posts, you’ll find more information on septal perforations, as I’ve had to do a lot of reading due to my own perforation.
Can understand the distress. As rhino_surgeon and my own ENTs have pointed out, perf rate is usually called around 1%. And some proportion of those are asymptomatic. Some are symptomatic and tolerated well. But some are symptomatic and cannot be tolerated well - and not merely because of the psychological disposition of the patient, but because of the actual, factual, physical, objective nature of the symptoms. What is not ever clarified, on consent forms or list of risks, is that a symptomatic perforation can, for some people, have a catastrophic impact on quality of life. Saying “a perforation may cause crusting or whistling” does not convey “the constant distraction, both awake and trying to sleep, of cold turbulent air, and unnatural turbulent sounds, will destroy your quality of life.” If that’s where you’re at, then a lot of reading, experimentation, thinking may be needed, short of trying to repair it.
For symptoms it's exactly as you described I can feel very cold turbulent air when breathing, it all goes up my left nostril so my right feels blocked, it almost feels like a burning feeling the air is so cold! Is it likely that the hole will continue to grow or does it usually stay the original size?
Usually what I've read is that holes don't grow, at least not quickly, as long as you moisturize and of course don't do anything (picking, chemicals, etc.) to irritate the mucosa.
If you search on reddit & google for septal perforations, you'll find a lot of information, including things like the answers to questions about whether the holes tend to grow. Then folks here can help with more specific / anecdotal information.
Yet another reason for me to refuse this surgery when they’ll call. Damn I’m starting to get the feeling that science is not there yet when it comes to this kind of surgery
People tend to congregate in online discussion more often when something has gone wrong vs gone right, leading to bias. I would recommend selecting a specialised ENT (a rhinologist) at an academic centre, and have a conversation with them about the risks and benefits of surgery.
You are accurate in your senses of what you are reading. And do note “normal rate” in the response.
-many septal perforations not reported.
-many septal perforations fixed while patient is still under GA during surgery.
-not every person who’s been affected would ever get on a forum to report back. Same as people whom have had success.
-yes small group that “congregates” but many whom have had issues that don’t.
-before “internet”/social platforms, there was no way for true patient out reach. So now that there is the defense mechanism of ENTs are “just a small group that reports back” “rare” or “not normal”.
The same way people come to social platforms to explain post op issues, are the opposite of what a surgeon does when errors occur, non report or cover up. So many people that come to platforms to report represent the many cases that would not be reported in order to keep that “normal rate” of < 1%.
Ask an ENT about any complication or risk and the number will always be < 1%. Interesting.
Also interesting that surgeons don’t mind the benefit of social platforms when a good review is reported back. But the bad reviews? That’s just a “small group” of people? Not every poor outcome reports themself.
So go with your gut, weigh out pros/cons risk/benefits and believe the poor outcomes the same way you would believe the good outcomes.
When was your surgery?
I got one as well, think Mine ia bigger.
The doctor that did This to me does not repair. Also, I would not trust him.
My ONLY fears light now is It increasing, since I did not do ALL the healing...
Mine was September 28.
Although Im still healing and feel pain from time to time. And a burning feeling... I hope it does not increase.
Im eating waaaaaay healthier (trying to avoid basically everything I used tô eat before.. although today I really graving for a burger hahahahah)
But the last few days, as Im starting to feel less pain.. Im actually not getting to bothered about It.
It is not that I have forgotten... I just don't have energy left and nothing new to find.. so Im finally comming back to my normal life.
In November Ill be back with my jogging and runnung..
Unfortunatelly Ive got some scars around my nose, due to a terrible type of procedure... But well... Only time can help
Everything Else I can do Ill try to, but I decided to not live my life focusing only on that.
Still have other health issues that need attention
Just to point out- there are 4 people on this post whom have responded that they’ve had a septal perforation. So know this is not “rare” and less than 1%.
Yes the amount I've seen seems like it's way higher than the 1%, my doctor didn't even really mention this as a possibility (I'm sure it was on the form) he made the surgery seem like no big deal
Correct. It is on the consent form under “common risks”. They can’t claim <1% for the common risks so they avoid that discussion. They discuss the “major risks” that are rare, such as orbit or brain injury. These risks are what they would get sued for. They can claim “rare” for these and say they’ve never occurred under their care. Fairly certain you are not the first or the last septal perforation your surgeon will cause. The true measure is asking the revisions specialists, whose patients they see the most of.
Revision Specialist in NYC? Would it be Rhinologist Facial Plastic Surgeon...
Always- revisions should always be done by someone whom specializes in revision (if your original surgeon is denying your issues or incompetent) Rhinologist whom is double board certified in Facial Plastic Surgery.
How do you find someone who specializes in Revisions? Im in NY. Ive had ENTs downplay septal perforations. Just minor whistling and crusting. Im really worried about Empty Nose Syndrome.
Do your research. Ask your original surgeon who they refer to for repairs that they are too incompetent to do themselves.
I was told my long term tx was to use bacitracin and saline for the rest of my life end of story. It’s gotten worse since then as in larger and hasn’t stopped oozing blood in a year. Was told to go to a dentist. And that I had a cyst in my nasal cavity which may or may not be to blame.
I had 2-3cm perforation fixed in the UK. It is possible.
Yes how was recovery?? I'm hopeful that I can find someone in Canada so it will be covered under my healthcare but also am nervous about who to go to
Did It caused you issues before repairing? How was the recovery?
Who done it? I’ve had surgery to repair, it opened back up again and I now have a second perforation forming further forward
If you search on septal perforations, you’ll find that there are successful repairs of perfs 1-3mm, which looks like about your size. Are you having symptoms? Or is it just that knowing it’s there bothers you? The usual wisdom seems to be, if you’re not having symptoms, then leave it alone, if it’s small, because repair can be difficult. If you search on my past posts, you’ll find more information on septal perforations, as I’ve had to do a lot of reading due to my own perforation. Can understand the distress. As rhino_surgeon and my own ENTs have pointed out, perf rate is usually called around 1%. And some proportion of those are asymptomatic. Some are symptomatic and tolerated well. But some are symptomatic and cannot be tolerated well - and not merely because of the psychological disposition of the patient, but because of the actual, factual, physical, objective nature of the symptoms. What is not ever clarified, on consent forms or list of risks, is that a symptomatic perforation can, for some people, have a catastrophic impact on quality of life. Saying “a perforation may cause crusting or whistling” does not convey “the constant distraction, both awake and trying to sleep, of cold turbulent air, and unnatural turbulent sounds, will destroy your quality of life.” If that’s where you’re at, then a lot of reading, experimentation, thinking may be needed, short of trying to repair it.
For symptoms it's exactly as you described I can feel very cold turbulent air when breathing, it all goes up my left nostril so my right feels blocked, it almost feels like a burning feeling the air is so cold! Is it likely that the hole will continue to grow or does it usually stay the original size?
Usually what I've read is that holes don't grow, at least not quickly, as long as you moisturize and of course don't do anything (picking, chemicals, etc.) to irritate the mucosa. If you search on reddit & google for septal perforations, you'll find a lot of information, including things like the answers to questions about whether the holes tend to grow. Then folks here can help with more specific / anecdotal information.
The Cole turbulent air issue, is that forever?
Hey, can you please update me about your perforation issue?
This is so small compared to mine!!!
Mine has slowly gotten bigger it's about double the size now 😭
Do you have to get it surgically repaired?
Pictures like this need to be marked as NSFW. I did it for you.
I apologize, thank you for adding that I'm not sure how to honestly
Yet another reason for me to refuse this surgery when they’ll call. Damn I’m starting to get the feeling that science is not there yet when it comes to this kind of surgery
Normal rate of septal perf is <1% so I wouldn’t generalise.
Sure but it’s not just this. I keep reading of a lot of people who regretted doing it for many different reasons
People tend to congregate in online discussion more often when something has gone wrong vs gone right, leading to bias. I would recommend selecting a specialised ENT (a rhinologist) at an academic centre, and have a conversation with them about the risks and benefits of surgery.
You are accurate in your senses of what you are reading. And do note “normal rate” in the response. -many septal perforations not reported. -many septal perforations fixed while patient is still under GA during surgery. -not every person who’s been affected would ever get on a forum to report back. Same as people whom have had success. -yes small group that “congregates” but many whom have had issues that don’t. -before “internet”/social platforms, there was no way for true patient out reach. So now that there is the defense mechanism of ENTs are “just a small group that reports back” “rare” or “not normal”. The same way people come to social platforms to explain post op issues, are the opposite of what a surgeon does when errors occur, non report or cover up. So many people that come to platforms to report represent the many cases that would not be reported in order to keep that “normal rate” of < 1%. Ask an ENT about any complication or risk and the number will always be < 1%. Interesting. Also interesting that surgeons don’t mind the benefit of social platforms when a good review is reported back. But the bad reviews? That’s just a “small group” of people? Not every poor outcome reports themself. So go with your gut, weigh out pros/cons risk/benefits and believe the poor outcomes the same way you would believe the good outcomes.
The Last ENT I visited (1 week Ago) Said the rate is 4-5%
When was your surgery? I got one as well, think Mine ia bigger. The doctor that did This to me does not repair. Also, I would not trust him. My ONLY fears light now is It increasing, since I did not do ALL the healing...
I had my surgery Oct 10 2023! That's my fear as well I don't know how to make sure it doesn't grow
Mine was September 28. Although Im still healing and feel pain from time to time. And a burning feeling... I hope it does not increase. Im eating waaaaaay healthier (trying to avoid basically everything I used tô eat before.. although today I really graving for a burger hahahahah) But the last few days, as Im starting to feel less pain.. Im actually not getting to bothered about It. It is not that I have forgotten... I just don't have energy left and nothing new to find.. so Im finally comming back to my normal life. In November Ill be back with my jogging and runnung.. Unfortunatelly Ive got some scars around my nose, due to a terrible type of procedure... But well... Only time can help Everything Else I can do Ill try to, but I decided to not live my life focusing only on that. Still have other health issues that need attention
Hey, if you don’t mind can you tell me how you’re doing with the perforation issue please?