Inside the nose is the nasal cavity, which is divided into two passages by the nasal septum. The nasal septum is composed of both bone and cartilage and extends from the nostrils to the back of the nose.
Ulcers (sores) and holes (perforations) in the nasal septum may occur as a result of
Repeated injury (such as from repeatedly picking the nose)
Exposure to toxins (such as acids, chromium, phosphorus, and copper vapor)
Chronic nasal spray use (including corticosteroids and over-the-counter phenylephrine or oxymetazoline sprays)
Pure oxygen inhaled through the nose, as is delivered through nasal prongs or a nasal mask
Diseases such as tuberculosis Tuberculosis (TB) Tuberculosis is a chronic contagious infection caused by the airborne bacteria Mycobacterium tuberculosis. It usually affects the lungs. Tuberculosis is spread mainly when people breathe... read more , leprosy Leprosy Leprosy is a chronic infection caused by the bacteria Mycobacterium leprae or Mycobacterium lepromatosis. It results in damage primarily to the peripheral nerves (the nerves outside... read more , granulomatosis with polyangiitis Granulomatosis with Polyangiitis Granulomatosis with polyangiitis often begins with inflammation of small- and medium-sized blood vessels and tissues in the nose, sinuses, throat, lungs, or kidneys. The cause is unknown. The... read more (formerly called Wegener granulomatosis), and syphilis Syphilis Syphilis is a sexually transmitted infection caused by the bacteria Treponema pallidum. Syphilis can occur in three stages of symptoms, separated by periods of apparent good health. It... read more
Frequent use of cocaine Cocaine Cocaine is an addictive stimulant drug made from leaves of the coca plant. Cocaine is a strong stimulant that increases alertness, causes euphoria, and makes people feel powerful. High doses... read more snorted through the nose (because it decreases blood flow)
Symptoms of Perforations of the Septum
Symptoms may include crusting around the ulcer or perforation and repeated nosebleeds. People who have small perforations in the septum may make a whistling sound when they breathe.
Diagnosis of Perforations of the Septum
A doctor's evaluation
Doctors examine the front part of the nose and, to view septal perforations, insert an endoscope (a flexible viewing tube) into the nose.
Treatment of Perforations of the Septum
Medicated ointment or saline nasal spray for ulcers
Rarely surgery for perforations
For septal ulcers, bacitracin ointment or mupirocin ointment reduces the crusting, as may saline nasal spray.
Doctors can sometimes surgically repair septal perforations using a person’s own tissue from another part of the nose or with an artificial membrane made of a soft, pliable plastic. Most perforations do not need to be repaired unless bleeding or crusting is a major problem.