Nasal septum perforation is a condition where there is a full thickness defect (or hole) of the nasal septum. The nasal septum divides the inside of the nose from the left and right cavities. Septum perforations can be caused by a variety of different factors such as trauma, autoimmune disorders, infection, neoplasm, nasal sprays, or drug use.
Today, we will talk about cocaine and how this can lead to nasal perforations! Cocaine was popularized in medicine in the 1880s. In 1905, there was increased usage of cocaine recreationally and snorting cocaine became extremely popular. Hospitals started reporting cases of nasal damage caused by using this drug.
Cocaine is a stimulant that causes blood vessels to constrict. When blood flow is compromised through continued use of cocaine, this causes lack of oxygen being delivered to the tissue. As a result, the tissue lining the cartilage as well as the cartilage will begin to die. Since cocaine also has a numbing effect, most people may not even notice that this is occurring. Once a nasal perforation is present, it cannot heal on its own.
Damage to the septum can cause changes in the appearance of the nose such as causing the nose to look collapsed (saddle nose deformity). In addition, perforations can increase complications during and after rhinoplasty. The size of the perforation and integrity of the septum are also factors which may affect the result of a rhinoplasty procedure. While this may sound discouraging, a safe rhinoplasty can still be performed for these patients by an experienced rhinoplasty surgeon. A consultation with an expert in advanced or complicated rhinoplasties would be best to discuss all possible options to achieve your aesthetic goals in a safe, predictable manner.