Surgery Overview
The nasal septum is the structure between the nostrils that separates the nasal passages. It's made of cartilage and thin bone. A hole (perforation) can form in the cartilage as a complication of previous nasal surgery, from cocaine use, excessive nose picking, trauma, cancer, or diseases such as tuberculosis, sarcoidosis, or syphilis. As damage reduces blood supply in the septum, the cartilage begins to die, and a hole forms.
Some perforations can cause bleeding, pain, and a whistling sound when you inhale. If dried blood or scabs build up, you could also have trouble breathing through your nose.
Many perforations don't need to be closed. Small holes may need only frequent rinsing with saltwater (saline) solutions and applying lubricating gels. You can buy these 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 hole.
Surgery for large perforations usually requires general anesthesia.
A doctor may want to try a nonsurgical technique to close the hole before suggesting surgery. In some cases, a doctor may insert septal "buttons" made of silicone or other materials that are cut to fit the hole.
