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
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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.