OpenHealth Q&A

Concerns Surrounding Septal Perforation for a 25-Year-Old Woman

**25-Year-Old Female - 5’0, 165 lbs - Questioning Septal Perforation Concerns** I recognize that this topic has been explored by others previously, and while responses might seem straightforward, I’m seeking some clarity to help alleviate my ongoing health-related anxiety. Currently, I perform Neil-med sinus rinses three times a day, and I maintain nasal moisture with products like Aquaphor, coconut oil, and nasal gel. This routine isn’t intended as a permanent solution, and I do plan to reduce these practices eventually, but I'm not quite ready for that yet. **Background Information:** - For over a decade, I have battled sinus complications. - I was born with a deviated septum, which has become increasingly noticeable with age. - After a CT scan in September, I was diagnosed with sinusitis, showing mucosal thickening but an intact septum. - Pain began in September and was initially thought to be a severe sinus infection. - In December, a swab test was conducted for Staph during this ongoing issue. - A course of Doxy was prescribed in January but I found little benefit. - In May, I was given a 21-day prescription of Amoxicillin-Clav with minimal improvement. - A 10-day course of monofloxacin in June effectively cleared the infection. During my doctor visit in **May**, she noted that my nasal passages appeared normal, prescribing treatment for chronic sinusitis. In my **June** follow-up, she expressed concern after examining the left side and contacted an ENT on call, initially suspecting an abscess. However, the specialist indicated that it was likely a localized infection resulting from the deviated septum. The monofloxacin treatment was effective up to that point, though no remarks were made about the right side, which she said looked fine. After a follow-up in **July**, my doctor informed me that although the infection cleared, there was still a noticeable bulging due to persistent inflammation. She conveyed no worries regarding this issue. When examining the right side, however—the previously declared healthy side—she observed significant scarring on the septum, claiming it is severely deviated. Given my overwhelming health anxiety, I’ve invested a lot of time trying to pinpoint the original cause of my symptoms. Now, after finally feeling better, I fear the possibility of a perforation without any awareness of it. Nevertheless, the ENT does not seem alarmed, and I have a long wait for my appointment—around six months. I do not exhibit any signs typically associated with perforation, such as bleeding or excessive pain. I use nasal plugs, but beyond that, the discomfort has resolved, with no crusting or nosebleeds noted. Recently, I’ve merely observed a thin layer of white tissue or mucus on both sides since completing the monofloxacin treatment. Could this indicate healing processes or the presence of immune cells? To date, I haven't experienced any symptoms that suggest cartilage has been damaged or that I’m at risk of perforation. Although I have occasionally burst a blood vessel due to forceful blowing, those instances resolve quickly with no other alarming symptoms suggesting an impending issue. When I inspect my nasal passages, I don’t see a hole and no light penetrates through. There is an indentation on the right side, but given my significant septum deviation, could this be considered normal? **In summary**: Since my health has improved, I have noticed increased congestion, mucus, and additional sneezing, alongside that thin layer of white tissue. It looks almost like peeling skin, very bright white in color. **My inquiries are as follows:** - Has anyone experienced anything similar? - Am I safe, or is there something I should be cautious about? - Do my symptoms indicate that a perforation is forthcoming, or am I overanalyzing? - Could this white tissue be a sign of healing or an immune response? Is it concerning? - What should I expect to see if I had actual scar tissue within my nose? - Would I be experiencing pain if that were the case? I acknowledge that I'm in charge of my health decisions and I'm not aiming to downplay any risks; I merely seek to understand the reality of my situation. With my ENT appointment at least six months away, the uncertainty drives me to distraction. While the alleviation of my original symptoms fills me with hope, my doctor's comments have left me feeling anxious. Thank you for any advice or personal stories you can share; it truly helps ease my mind.

Answers (1)

7/3/2025, 10:20:54 PM

OpenHealth AI

It's completely natural to feel anxious about health concerns, especially with a complex history like yours. Your symptoms and ongoing management of sinus issues have led to understandable worries about potential complications like septal perforation. Let's clarify your concerns and give you actionable steps to take.

Key Points:

1. Your nasal symptoms, current management, and recent improvements do not strongly indicate an impending septal perforation.
2. The white tissue you’re observing could be a normal healing response.
3. Monitoring your symptoms is crucial, but there are ways to manage your anxiety and maintain nasal health until your ENT appointment.

Explanation:

Given your history of sinusitis and your deviated septum, it's normal to experience ongoing congestion and mucus production. The fact that you do not experience typical signs of septal perforation—such as persistent nosebleeds, severe pain, or airflow from one nostril to the other—is encouraging. The white tissue you see may represent healing tissue, which can sometimes appear when the body is repairing itself from inflammation or minor irritation after an infection.

Next Steps:

1. Continue Nasal Care:

• Maintain your Neil-med sinus rinses and nasal moisturizers, as they can help keep your nasal passages clean and comfortable. Aim to gradually reduce frequency when you feel ready.

2. Monitor Symptoms:

• Keep a daily symptom diary to track changes. Note when congestion worsens or improves, any changes in the appearance of nasal discharge, and any other symptoms you may experience.

3. Manage Health Anxiety:

• Engage in relaxation techniques such as deep breathing exercises, yoga, or mindfulness meditation. This can help ease your worries about potential complications.

4. Maintain Communication:

• If your symptoms evolve—especially if you experience unexpected bleeding, significant pain, or changes in the appearance of your nasal passages—consider reaching out to your healthcare provider sooner than your scheduled ENT appointment.

5. Understand What to Look For:

• Typical symptoms of septal perforation may include persistent nasal bleeding, a whistling sound when breathing through your nose, or significant pain. If you’re not experiencing these, the risk of perforation appears low.

6. Seek Support:

• Consider joining a support group or community for individuals with similar chronic conditions. Sharing experiences can be very reassuring.

Keep in mind that while it’s good to stay informed, focusing too much on potential issues can heighten anxiety. Each step you take towards understanding your health can empower you. If you have further questions or concerns, feel free to share. You're not alone in this journey!