What is it?

The two cavities of the nose are separated by a septum. The nasal septum is made from bone and cartilage, and it helps with airflow in the nasal passages. The septum can become damaged in several ways, leading to complications. One type of injury to the septum is when a hole develops in it. This is known as a perforated septum. It can cause symptoms that vary from very mild to severe.

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Signs & symptoms

Symptoms of a perforated septum will vary from person to person. Often, the symptoms will depend on the size of hole in the septum:
* wheezing through the nose
* crusting of the nose
* scabbing in the nose
* feeling of obstruction in the nose
* nosebleeds
* runny nose
* nose pain
* headache
* malodorous smell in the nose

Diagnosis

Septal perforation is diagnosed by an endoscopic examination of the nasal cavity. In some cases, additional testing such as blood work or a biopsy of the perforation may be needed to rule out causes.

Treatment

Your doctor will aim to treat the underlying cause (if found), decrease the symptoms caused by the perforated septum, and close the hole if possible or necessary.
There are many first-line treatments you can try to reduce symptoms of a perforated septum, such as:
* irrigating with saline sprays in the nose
* using a humidifier
* applying an antibiotic ointment

Another nonsurgical method involves using a prosthesis in the nose to plug the hole in the septum. This is described as a prosthetic button. The doctor can insert the button with a local anesthesia. The prosthetic may be a generic-sized button or one custom made to your nose. These buttons can seal your septum and may reduce symptoms. There are certain button types available where you can remove the button daily for cleaning purposes.

It may be necessary to try surgery to repair the septum and eliminate the hole. The doctor may only be able to repair a small hole in the septum. This can be a complicated surgery that only specialized doctors can perform. This type of procedure requires general anesthesia and an overnight hospital stay for monitoring and recovery. Your doctor may cut your nose on the underside and move tissue to fill the hole in your septum. Your doctor may even use cartilage from your ears or ribs to repair the septum.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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