Abstract

Practically every nasal septal perforation can be repaired for function, even in extreme cases in which a posterior crescent shaped asymptomatic defect may happen to remain. Only a hole in the posterior bony part of the septum, which is extremely rare, may remain untreated because it doesn't always cause problems. Nasal septal perforations may lead to significant upper airway problems as well as aesthetically disturbing changes for the external contour of the nose. I have the impression that the overall incidence of nasal septal perforations is decreasing. This is because of application of improved rhinosurgical techniques and renouncement the Killian-type of submucous septum resection as one of the greatest contributors to the cause of nasal septal perforations. However, although the incidence of nasal septal perforations is declining, I find the diameter of nasal septal perforations that patients present with, to be enlarging. The increase of the use of intranasally applied cocaine seems to be responsible.

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