I am curious about a perforated septum. Should I see an ENT?

Hi,

Welcome to icliniq.com.

I understand your concern. As I can see in the pictures (the attachments rae removed to protect the patient's identity), it is blurry. You seem to have right DNS (deviated nasal septum) that red bulge what you can make out, and the left caudal dislocation of the septum is also present. Please answer a few questions so I can guide you on whether an ENT (ear, nose, and throat) doctor appointment is needed. 1. Do you have nasal obstruction? If present, on which side? 2. History of sneezing or loss of smell or nasal bleeds? 3. Why do you suspect you have a perforated septum? Have you undergone any nasal septal surgery before? I hope you find it helpful. Kind regards.

Hi,

Welcome back to icliniq.com.

I understand your concern. From the images you sent, all I can see is a nasal bulge. But to know the perforation will have to do a diagnostic nasal endoscopy. Yes, substance abuse can cause perforation. Although the plugs that you complain about can be a part of perforation, you do not have any other symptoms of perforation like nasal obstruction, nasal bleeds. Are you getting any whistling sounds from the nose? Kind regards.

Hi,

Welcome back to icliniq.com.

I understand your concern. I can make out a small black spot in the recent picture (the attachments are removed to protect the patient's identity). Please check it once again. It is the beginning of the perforation. The mucosa has turned black, which means it is starting to necrose. If the habit is not stopped, the cartilage will necrose and then opposite side mucosa, ultimately leading to septal perforation. Please confirm to me whether there is just a black spot or if you can look through the opposite nasal side from that black spot. I hope you find it helpful. Kind regards.

Hi,

Welcome back to icliniq.com.

I understand your concern. Then I do not think so. The necrosis of the cartilage has started. Please stop abuse, which decreases the vascularity at that site and leads to perforation. I suggest vaseline (Paraffin) to that black spot three to four times a day; if there is too much crusting, use saline nasal drops to soften the crusts, then remove the crusts. It is an early stage of perforation that can be healed if proper care is given and substance abuse is stopped. I hope you find it helpful. Kind regards.