Can a Septal Perforation Heal on Its Own?
Prof. Dr. Gediz Murat Serin | ENT and Facial Surgery Specialist
A whistling sound from the nose, recurrent nosebleeds, persistent dryness, and crusting… Many patients live with these complaints for a long time, yet the underlying cause often goes unnoticed: a septal perforation, a hole in the nasal septum.
In this article, I will clarify the frequently asked and important question:
“Can a septal perforation heal on its own?”
I will also explain why this condition requires a personalized and meticulous evaluation and emphasize the importance of modern surgical approaches.
What is a Septal Perforation?
The structure that separates the right and left nasal passages is called the nasal septum. It consists of cartilage in the front, bone in the back, and is lined with mucosa (nasal lining) on both sides.
A hole—called a perforation—in this septum disrupts the natural airflow in the nose, upsets the moisture balance, and gradually causes symptoms that negatively affect quality of life.
Can a Septal Perforation Heal on Its Own?
Short answer: Usually no.
However, each case should be evaluated individually. Spontaneous closure may only be possible under certain conditions:
- If the perforation is very small (less than 2–3 mm)
- If it is newly formed (within the first 1–2 weeks)
- If it was caused by trauma or surgery
- If the mucosal integrity is still preserved
In such limited cases, the perforation may theoretically heal. However, the constant airflow inside the nose hinders healing in that region. The turbulence caused by the airflow leads to tissue drying and cracking, reducing the chance of closure. Therefore, the expectation of “spontaneous healing” is often unmet, and healing remains incomplete or unstable.
What Happens If the Perforation Doesn’t Heal?
Septal perforations that are not treated in time typically enlarge.
As the perforation grows, the following problems may occur:
- Significant deterioration in breathing quality
- Whistling sound heard with every breath
- Crusting, bleeding, and bad odor
- Dryness, cracking, and infections in the nasal mucosa
- In advanced cases, aesthetic deformity of the nose
Moreover, repairing a larger perforation surgically becomes more technically challenging and requires a more complex intervention. That’s why early diagnosis and timely treatment are critically important.
Not All Septal Perforations Are the Same
Throughout my nearly 20 years of experience in rhinology (nasal diseases), I’ve clearly observed this:
Every septal perforation is different. The size, location, shape, cause of formation, and nasal structure of the patient are unique in each case. Therefore, applying a one-size-fits-all surgical approach to every patient would be a mistake.
In my own practice, I use a personalized surgical technique that goes beyond classical approaches. This method aims to permanently close the perforation using the patient’s own tissue.
A Permanent Solution with My Developed Surgical Technique
In the technique I’ve developed and have successfully used for many years, a thin fascia lata graft taken from the patient’s upper thigh is used. This tissue is shaped using special surgical techniques and placed inside the nose.
In necessary cases, I also use rib cartilage for support to ensure both structural and functional repair.
This technique:
- Can be combined with closed (endoscopic) or open rhinoplasty,
- Addresses both aesthetic and functional needs in the same session,
- Minimizes the risk of recurrence,
Why Delaying Treatment Is Risky
Some patients wait for years thinking, “Maybe it will go away.” But this delay often causes the perforation to enlarge and the symptoms to become chronic. In advanced cases, both the scope of the surgery increases and the recovery period lengthens.
Delaying treatment:
- Makes necessary surgery more difficult
- Lowers quality of life
- Can lead to psychological distress
However, with the right technique and timely surgery, patients can regain their comfort in a healthy way.
Conclusion: Early Intervention and an Experienced Surgeon Are Essential
A septal perforation is not a condition to be neglected. Spontaneous healing is rare and often insufficient. A permanent and effective solution is only possible through proper intervention by an expert surgeon.
As Prof. Dr. Gediz Murat Serin, with years of clinical and academic experience dedicated to nasal surgery, I offer a patient-specific and scientifically grounded approach. Thanks to the surgical technique I have developed, it is possible to achieve results that are both aesthetically satisfying and functionally healthy.
