From the Research
Treatment for a nasal septal perforation in children typically involves conservative management, including saline nasal sprays and petroleum jelly or antibiotic ointment, to reduce symptoms and improve quality of life, with surgical repair considered for symptomatic cases, usually delayed until adolescence 1, 2. The goal of treatment is to alleviate symptoms, prevent complications, and improve the child's quality of life.
- Conservative management is often recommended for small, asymptomatic perforations, and includes:
- Saline nasal sprays to keep the nasal passages moist and prevent crusting
- Petroleum jelly or antibiotic ointment applied to the edges of the perforation to promote healing
- Humidification of the child's environment to prevent dryness
- Surgical repair may be considered for symptomatic cases, such as those with whistling during breathing, recurrent nosebleeds, or crusting, and typically involves:
- Septal button placement (a silicone prosthesis that blocks the hole)
- Formal surgical closure using tissue grafts
- Delaying surgery until the child is older, often into adolescence, when facial growth is more complete, as suggested by a study published in 2017 2 The most common causes of septal perforations in children include:
- Trauma (such as nose picking or injury)
- Previous nasal surgery
- Inflammatory conditions
- Infections Addressing the underlying cause is essential for successful management, and parents should be counseled to discourage nose picking and to seek prompt treatment for nasal infections to prevent complications, as highlighted in a study published in 2021 1.