A Well-Studied Disease-Resistance Gene Shows No Signs of Selection

Background: Septal perforation is an uncommon but very bothersome illness and treatment is difficult particularly with large perforations. We wanted to establish the etiology and size of nasal septal perforations in an attempt to implement preventive measures. Methods: This is an open, prospective clinical study of patients seen at our hospital from 1981 to 2005. The clinical data of size, gender and etiology have been recorded consecutively. Results: One hundred and ninety seven patients (100 male, 97 female) were evaluated. Between 1981 and 1995 nasal septal perforation was caused by surgery in 40 of 102 (39.2 %). In the period 1995 to and inclusive of 2005 this percentage decreased as septal resection has been replaced by septo/septorhinoplasty. The latter was the cause for septal perforation in 14.7% in the last period. Nasal steroid and decongestive sprays have emerged as an important cause (28.4 %) during the last ten years particularly in females. In the first period 44 (43.1 %) and in the last 53 (55.7 %) patients were females. There was a noticeable reduction in the number of septal perforations 15 mm or larger in the last period. Conclusion: Nasal steroid and decongestive sprays are now important causes for septal perforation. Information about this complication should be given with an advice to immediately report increasing and bothersome crusting and bleeding. Warning of the simultaneous use of nasal steroid and decongestive sprays should be addressed particularly to females. All patients with symptoms of septal perforation should promptly be referred to otolaryngologists for treatment. Background The treatment of nasal septal perforation (SP) is symptomatic (local application of ointments), prosthetic, or surgical. Surgery may be curative but the results are not always satisfactory as evidenced by the many different operative procedures that have been proposed [1-7]. Prevention of SP should be an important goal. The purpose of this study was to examine our clinical data to look for possible changes in the pattern of etiology in order to identify causes that may be suitable for preventive measures. We have also registered the size of the SP in order to establish whether the size would indicate that the patients should have been referred sooner. Methods We have recorded the etiology, symptoms and the size of SP from 1981 to and inclusive of 2005. To establish the cause of a SP we have relied on the case history, the time Published: 7 March 2007 BMC Ear, Nose and Throat Disorders 2007, 7:1 doi:10.1186/1472-6815-7-1 Received: 12 October 2006 Accepted: 7 March 2007 This article is available from: http://www.biomedcentral.com/1472-6815/7/1 © 2007 Døsen and Haye; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.