Septal<unk> s are managed with a multitude of options. The treatment often depends on the severity of symptoms and the size of the<unk> s. Generally speaking anterior septal<unk> s are more bothersome and symptomatic. Posterior septal<unk> s, which mainly occur iatrogenically, are often managed with simple observation and are at times intended portions of skull base surgery. Septal<unk> s that are not bothersome can be managed with simple observation. While no septal<unk>  will spontaneously close, for the majority of septal<unk> s that are unlikely to get larger observation is an appropriate form of management. For<unk> s that bleed or are painful, initial management should include humidification and application of salves to the<unk>  edges to promote healing. Mucosalization of the<unk>  edges will help prevent pain and recurrent epistaxis and majority of septal<unk> s can be managed without surgery. For<unk> s in which anosmia, or the loss of smell, and a persistent whistling are a concern, the use of a silicone septal button is a treatment option. These can be placed while the patient is awake and usually in the clinic setting. While complications of button insertion are minimal, the presence of the button can be bothersome to most patients. For patients who desire definitive close, surgery is the only option. Prior to determining candidacy for surgical closure, the etiology of the<unk>  must be determined. Often this requires a biopsy of the<unk>  to rule out autoimmune causes. If a known cause such as cocaine is the offending agent, it must be ensured that the patient is not still using the irritant. For those that are determined to be medically cleared for surgery, the anatomical location and size of the<unk>  must be determined. This is often done with a combination of a CT scan of the sinuses without contrast and an endoscopic evaluation by an Ear Nose and Throat doctor. Once dimensions are obtained the surgeon will decide if it is possible to close the<unk> . Multiple approaches to access the<unk>  have been described in the literature. While sublabial and midfacial degloving approaches have been described, the most popular today is the rhinoplasty approach. This can include both open and closed methods. The open method results in a scar on the columella, however, it allows for more visibility to the surgeon. The closed method utilizes an incision all on the inside of the nose. The concept behind closure includes bringing together the edges of mucosa on each side of the<unk>  with minimal tension. An interposition graft is also often used. The interposition graft provides extended stability and also structure to the area of the<unk> . Classically, a graft from the scalp utilizing temporalis fascia was used. Kridel, et al., first described the usage of acellular dermis so that no further incisions are required; they reported an excellent closure rate of over 90 percent. Overall<unk>  closure rates are variable and often determined by the skill of the surgeon and technique used. Often surgeons who claim a high rate of closure choose<unk> s that are easier to close. An open rhinoplasty approach also allows for better access to the nose to repair any concurrent nasal deformities, such as saddle nose deformity, that occur with a septal<unk> .
Nasal septum perforation
Nasal septal hematoma
Nasal septal abscess
Nasal fracture
Nasal polyp
Epiglottitis
Adenoiditis
Laryngocele