Learning Curve and Importance of Experience in Septum Perforation Surgery
Prof. Dr. Gediz Murat Serin
Introduction
Septum perforation, commonly known as nasal hole, is a condition that seriously affects patients’ quality of life both aesthetically and functionally. Patients may present with the following complaints:
- Whistling sound inside the nose
• Dryness and crusting
• Recurrent bleeding
• Nasal congestion
• Breathing difficulties
While these surgeries were rarely performed in the past, nowadays septum perforation surgery is becoming more prominent, especially with the development of advanced techniques. I have been performing septum perforation surgery for over 10 years. During this process, I have tried different techniques repeatedly, developed my own methods, and witnessed this reality: This surgery is not like other nasal surgeries. Septum perforation surgery requires a distinct learning curve. In other words, it is not possible to master it with just a few surgeries; experience, patience, and a large number of case experiences are essential.
Why is Septum Perforation Difficult?
While surgical planning is more predictable in most nasal surgeries, septum perforation surgery presents us with a different picture in each patient:
1. The size and location of the perforation differ: Surgical planning changes completely between small perforations and large perforations.
2. Mucosal quality: Previous surgeries may have left damage to the tissue, which limits the techniques to be used.
3. Vascularization: A healthy vascular support is required for the perforation to close. This is the most critical factor for success.
4. Additional diseases: Chronic sinusitis, septum deviation, turbinate hypertrophy, or accompanying aesthetic nasal problems make surgery more complex.
Therefore, septum perforation treatment is not a simple suturing surgery, but an advanced reconstructive intervention.
Why is the Learning Curve Important?
As I have also observed in my clinical practice, the success rate is directly related to the surgeon’s experience.
– Early years: Usually simpler techniques are applied to smaller perforations. However, success is not always guaranteed. The surgeon learns to combine different methods over time (for example, flap + graft-supported repairs).
– After 10 years: The surgeon now develops their own “signature techniques.” They can much more clearly predict which method will work for which patient.
This process has developed the same way in my practice. In the early years, I experienced some failures because performing this surgery perfectly requires long experience. However, each case taught me something new. Today, I achieve much higher success rates, especially in complex cases.
Points Patients Should Know
Septum perforation surgery is not a procedure that every surgeon can easily perform.
– Patients undergoing surgery for the first time: Choosing the right surgeon is very important.
– Patients who have previously undergone unsuccessful repair: There is still a chance for revision with the right technique and an experienced surgeon.
In my approach, a special plan is made for each patient. The patient’s perforation size, condition of nasal tissues, accompanying problems such as chronic sinusitis or septum deviation are evaluated in detail.
Conclusion
Septum perforation surgery is a special surgery that requires patience and experience gained over many years. The success rate is affected not only by the technique used, but also by the surgeon’s experience, case diversity, and post-operative follow-up.
At the point I have reached today, I can successfully repair perforations of different sizes and difficulties with high rates, and ensure that patients are satisfied both functionally and aesthetically.
📌 In summary: Septum perforation treatment is a journey that requires knowledge, patience, and experience. Each case is a new lesson, each surgery is a step towards better outcomes. Therefore, choosing the right surgeon is of great importance for patients.
