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
Nasal surgery
Repeated injury (such as from repeatedly picking the nose)
Cosmetic piercing
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
Autoimmune disorders or infections such as tuberculosis Tuberculosis (TB) Tuberculosis is a chronic contagious infection caused by the airborne bacteria Mycobacterium tuberculosis. It usually affects the lungs, but almost any organ can be involved. Tuberculosis... read more
, leprosy Leprosy Leprosy is a chronic infection usually caused by the bacteria Mycobacterium leprae or Mycobacterium lepromatosis. It results in damage primarily to the peripheral nerves (the nerves... 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. It can occur in three stages of symptoms, separated by periods of apparent good health. Syphilis... 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
Sometimes, laboratory studies and/or biopsy
Doctors examine the front part of the nose and, to view septal perforations, insert an endoscope (a flexible viewing tube) into the nose. If doctors suspect an infection or autoimmune disorder is the cause of the perforation, cultures for infection, other blood tests, and biopsy may be required.
Treatment of Perforations of the Septum
Medicated ointment or saline nasal spray for ulcers
Rarely surgery for perforations
Sometimes, medications to treat infection or autoimmune disorder
For septal ulcers, 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.
Medications are given if the cause of the perforation is an infection or an autoimmune disorder.
Drugs Mentioned In This Article
| Generic Name | Select Brand Names |
|---|---|
phenylephrine |
4-Way Nasal, Ah-Chew D, AK-Dilate, Anu-Med, Biorphen, Formulation R , Foster & Thrive Nasal Decongestion, Gilchew IR, Hemorrhoidal , Little Remedies for Noses, Lusonal, Mydfrin, Nasop, Nasop 12, Neofrin, Neo-Synephrine, Neo-Synephrine Cold + Allergy, Neo-Synephrine Extra Strength, Neo-Synephrine Mild, Ocu-Phrin, PediaCare Children's Decongestant, PediaCare Decongestant, PediaCare Infants' Decongestant, Sinex Nasal, Sudafed PE, Sudafed PE Children's Nasal Decongestant , Sudafed PE Congestion, Sudafed PE Sinus Congestion, Sudogest PE, Vazculep |
oxymetazoline |
12 Hour Nasal , Afrin, Afrin Extra Moisturizing, Afrin Nasal Sinus, Afrin No Drip Severe Congestion, Dristan, Duration, Genasal , Mucinex Children's Stuffy Nose, Mucinex Full Force, Mucinex Moisture Smart, Mucinex Sinus-Max, Mucinex Sinus-Max Sinus & Allergy, NASAL Decongestant, Nasal Relief , Neo-Synephrine 12-Hour, Neo-Synephrine Severe Sinus Congestion, Nostrilla Fast Relief, Reliable-1 12 hour Decongestant, Rhinase D, RHOFADE, Sinex 12-Hour, Sudafed OM Sinus Cold Moisturizing, Sudafed OM Sinus Congestion Moisturizing, Upneeq, Vicks Qlearquil Decongestant, Vicks Sinex, Vicks Sinex Severe, Visine L.R., Zicam Extreme Congestion Relief, Zicam Intense Sinus |
cocaine |
GOPRELTO, NUMBRINO |
mupirocin |
Bactroban, Centany, Centany AT |
