Author(s)
Travis Haller, MD
Michael Yim, MD
Gretchen Oakley, MD, FARS
Affiliation(s)
1) Department of Otolaryngology – Head and Neck Surgery, Mayo Clinic, Rochester, MN
2) Division of Otolaryngology – Head and Neck Surgery, University of Utah, Salt Lake City, UT
3) Department of Otolaryngology – Head and Neck Surgery, LSU Health Shreveport, Shreveport, LA
Abstract:
Objectives: This study aimed to identify characteristics of nasal septal perforations of unknown etiology and compare them with nasal septal perforations with known causes.
Study Design: Retrospective Case Series.
Methods: A pool of 160 adult patients with nasal septal perforations were identified between 2002 and 2018 at the University of Utah. Information including etiology, symptoms, perforation size, workup and treatment were recorded. Collected laboratory data included, but was not limited to: CBC, BMP, ESR, CRP, ANCA, ANA, RPR and pathology (if biopsied).
Results: Of the 160 patients evaluated, 85 (53%) patients had NSPs of unknown etiology. Known diagnoses included: surgery (41%), trauma (20%), autoimmune (17%), drugs/toxins (17%), neoplasm (3%), and infection (1%). NSPs of known etiologies were significantly more symptomatic (obstruction, whistling, crusting, bleeding) compared to unknown NSPs. The average perforation size for known etiologies was 17.28mm compared to 17.36mm for unknown. Biopsies were obtained in 24/75 (32%) patients with known NSPs etiologies compared to 1/85 (1%) of unknown NSPs (p<0.01). 35/75 (47%) patients with known NSPs had at least one autoimmune laboratory data obtained compared to 18/85 (21%) patients with unknown NSPs (p<0.01).
Conclusion: NSPs of known etiology were more likely to have significant symptoms, and also have had a workup involving laboratory and pathological evaluation. Further studies are needed to determine the appropriate utilization of these areas when assessing NSPs.