The nasal septum is the structure between the nostrils that
separates the nasal passages. The septum, composed of cartilage and thin bone,
can develop a hole (perforation) in the cartilage as a complication of previous
nasal surgery, from cocaine use, excessive nose picking, trauma, cancer, or
diseases such as
syphilis. As damage reduces blood supply in the
septum, the cartilage begins to die, and a hole develops.
Some perforations can cause bleeding, pain, and a whistling sound
when inhaling. If dried blood or scabs build up, you could also have trouble
breathing through your nose.
Many perforations do not need to be closed. Small perforations may
need only frequent rinsing with
saltwater (saline) solutions and applying lubricating
gels. Both can be bought without a prescription.
Several surgical techniques may be used to close a larger
perforation. A surgeon may use tissue from inside your nose or from another
part of your body (autograft) to stitch into the hole. Other doctors may use
tissue to create a flap to cover the perforation.
You will begin
rinsing the nose several times a day with saline. Your doctor will instruct you
on how to use the saline. You can expect drainage after surgery.
You may need to have your nose cleaned in the doctor's office a few
times. Your nose should be healed 2 to 3 weeks after the nasal pack is
Avoid blowing your nose, strenuous exercise, and bending forward
for a few days. Also take care not to injure your nose during exercise or other
Why It Is Done
Some nasal septal perforations can cause symptoms such as bleeding
and pain. Small perforations can create a whistling sound when you inhale. In
cases of long-term, severe perforation, the bridge of the nose can develop a
saddle-shaped deformity. Surgery can resolve these problems.
How Well It Works
Surgery to repair a nasal septal perforation is usually successful.
But some large perforations may be hard to close.
Bleeding and infection can occur after any surgery. You should
contact your doctor if you have:
Heavy bleeding. Mild bleeding is
A fever of
101°F (38.3°C) or higher.
pain. Mild pain is expected.
A foul smell coming
from the nose.
A persistent headache.
Sometimes the perforation may reopen and need another
What to Think About
Success of surgery depends to some extent on the size of the
perforation and also on proper
postsurgery care at home. Large perforations are more difficult to close.
The repair may not be as successful in people who smoke or have
diabetes as in other people, because these conditions
can reduce blood supply to the septum.
A doctor may want to try a nonsurgical technique to close the
perforation before suggesting surgery. In some cases, a doctor may insert
septal "buttons" made of silicone or other materials that are cut to fit the
Other Places To Get Help
American Rhinologic Society
P.O. Box 495
Warwick, NY 10990-0495
The American Rhinologic Society is an organization for doctors who treat people with diseases of the nose and sinuses. Patients and other interested individuals can use this Web site to find information about diseases of the sinuses and nose. Doctors and other health professionals can use this Web site to learn about all ARS activities, including scientific meetings and abstracts.
American Academy of Otolaryngology—Head and Neck Surgery
1650 Diagonal Road
Alexandria, VA 22314-2857
The American Academy of Otolaryngology—Head and Neck
Surgery (AAO-HNS) is the world's largest organization of physicians dedicated
to the care of ear, nose, and throat (ENT) disorders. Its Web site includes
information for the general public on ENT disorders.
How this information was developed to help you make better health decisions.