Do you have a hole in the wall inside your nose? (Perforated Septum) Let's talk about this!

Do you sometimes feel a strange, dry feeling inside your nose? Or do you hear a slight whistling sound when you breathe? These may not just be symptoms of a cold. Today we are going to talk about a condition that is less commonly heard, but is very important to be aware of.

Simply put, what is a perforated septum?

Okay, let's first look at what this nasal wall is. You have two nostrils, right? That part that separates the two nostrils, which is made up of a membrane inside (called the `mucosa` membrane) and a slightly softer part called `cartilage` , and also a part of bone, is what we call the inner wall of the nose , or the `septum` . It's like a wall between two rooms. This is why when we breathe through our noses, air enters through two passages.

Now, a perforated septum is when a hole, a gap, or a crack forms in the wall that separates the two nostrils for some reason. Think of it like a small hole in the wall that separates the two rooms. Sometimes this hole weakens the wall of the nose, and you can develop symptoms. Then you have to get treatment. However, this is not always serious. Some people can have this hole without any problems or symptoms. In such cases, instead of treating it, a doctor may tell you to keep an eye on it.

Do you have these characteristics?

Sometimes you may not even know you have a hole in the wall of your nose. This means that there may be no symptoms. However, if symptoms do appear, they can be quite bothersome. See if these symptoms sound familiar to you:

• Dryness and crusty buildup inside the nose: If your nose is constantly dry and feels like it has small crusts forming inside.
• A saddle nose deformity: Some people may find that the top of their nose, such as the bridge, appears to be slightly sunken in. This is called a saddle nose deformity .
• Nasal congestion: Difficulty breathing, feeling like your nose is blocked.
• Nosebleeds: If you have frequent nosebleeds.
• Runny nose: If you have a runny nose without even having a cold.
• Whistling sound when breathing through the nose: If you hear a slight whistling sound from your nose, especially when taking a deep breath.

Can I touch it with my finger? Is it okay to do that?

Yes, sometimes you can poke your finger into the hole and get a good look. But that's not a good thing, is it? Just don't do that. Because when you try to poke your finger into your nose, the pressure can tear the nasal tissue even more, making the hole bigger. Also, bacteria on your finger can get into your nose and cause an infection . That can make things worse.

So, the best thing to do is to see a doctor and get checked out. They will look at it and tell you exactly what's wrong.

Why is this happening? What are the reasons?

The main reason for a hole in the nasal wall is damage to the blood vessels inside the nose. When such damage occurs, the blood flow to the nasal wall can be disrupted. Then, those tissues do not receive the necessary nutrition, they weaken, and eventually a hole can form. Let's see what are the specific reasons that affect this:

• Autoimmune diseases: Simply put, these are diseases in which our body's own immune system attacks our own cells. For example, diseases such as granulomatosis with polyangiitis , lupus, and rheumatoid arthritis can cause these types of holes.
• Drug abuse: Excessive use of some steroid nasal sprays , or snorting drugs like cocaine, can damage the lining of the nose and cause holes. These are very dangerous.
• Exposure to chemicals: If your job requires you to constantly inhale harmful chemicals like chrome , that can also damage this delicate tissue.
• Infections: Some types of infections, such as tuberculosis and syphilis, can also cause holes in the nasal wall.
• Injuries: These holes can also be caused by things like a broken nose, a hard blow to the nose in an accident, or constant nose picking. Some people just pick their nose out of habit, which is also not a good thing.
• Nasal conditions: These cracks can also be caused by conditions such as atrophic rhinosinusitis and chronic rhinosinusitis (long-term inflammation of the nose and sinus cavities).
• Complications of medical treatment: Sometimes, during surgery on the nasal wall, such as a septoplasty , or during a procedure called electrocauterization to stop frequent nosebleeds, the doctor can accidentally damage this tissue. However, this is very rare.
• Tumors: Although very rare, certain types of tumors that develop inside the nose can also cause these holes. The main type of cancer associated with a hole in the nasal wall is squamous cell carcinoma .

How does a doctor detect this?

When you go to see a doctor, he or she will first ask about your medical history . This means you need to tell the doctor about any previous illnesses you have had, any surgeries you have had, and the medications you are taking (whether they were prescribed by a doctor, bought from a pharmacy, or other drugs). To make an accurate diagnosis, the doctor needs to have a complete picture of your health.

Then, the doctor will examine your nose. They may also do a test called a nasal endoscopy . This involves inserting a thin, flexible tube with a small camera and light on the end into your nose to examine the inside of your nose. It can also take pictures of the inside of your nose.

If the doctor suspects that the hole is caused by an infection, he or she will order some blood tests . Also, if there is a lump inside the nose, a biopsy ( a small sample of the lump is taken for testing) may be done to see if it is cancerous.

What are the treatments?

Treatment depends on how severe your symptoms are, the size of the hole, and whether the hole has caused damage or weakness to the structure of your nose.

Things you can do at home and medications

In most cases, there are home remedies for this hole in the wall of the nose.

• Your doctor may prescribe antibiotic ointments or nasal sprays containing emollients (those that help keep the skin moist).
• Your doctor may also recommend using a humidifier to keep the room moist, or using saline rinses or nasal irrigation regularly. These treatments help keep the inside of your nose moist. This can help reduce your symptoms, help clear up crusting, and help prevent the hole from getting bigger.

A small button for the nose (`Prosthetic button`)

Sometimes, the doctor may insert something like a prosthetic button into the nose to close the hole. This is like a shirt button, but it is made to fit the hole inside the nose. Some are made specifically for your nostril, while others are pre-made. This button can be a single piece, or it can come in two pieces that fit together inside the nose. However, these are made from medically safe materials, such as silicone .

Depending on your condition, the doctor may put you under general anesthesia (meaning you're asleep) when they insert this button. Or, they may do it in the office, where they numb just the area around your nose.

Even if you have a prosthetic button like this, it's very important to keep the inside of your nose moist. You need to continue to do things like use the humidifier mentioned earlier and rinse your nose with saline water.

Surgery

If other treatments don't work, or if your doctor thinks you're a good candidate for surgery, you may have surgery to close the hole. There are a variety of surgical techniques that your surgeon can use. He or she will choose the treatment that best suits your condition.

When should I see a doctor?

If you suspect that you have a hole in the nasal septum based on your symptoms, you should definitely see a doctor. There are many other conditions that can cause similar symptoms. Therefore, you should see a doctor to get an accurate diagnosis and the best treatment plan for you.

What can be expected with this situation?

A hole in the wall of your nose won't heal on its own. But that doesn't mean you need to get treatment right away. For many people, home remedies can help manage symptoms and prevent the hole from getting bigger. You and your doctor may decide that it's best to just keep an eye on the hole.

But if you need to have any treatment, whether it's a button insertion or surgery, the doctor will explain the pros and cons of each treatment option to you. They will also tell you why they recommend one treatment option over another.

Whether or not a hole in the wall of your nose will cause you any problems depends on the size of the hole, its location, and the cause of the hole. Your doctor will take all of these factors into consideration and decide whether your condition needs observation or treatment. So, if you suspect you have a hole like this, see a doctor right away. Depending on your condition, they may be able to repair it or help you manage it without any problems.

Finally, things to remember

So, a hole in the wall of the nose, called a perforated septum , can sometimes be asymptomatic, but can also cause bothersome symptoms.

• Be aware if you have symptoms such as a dry nose, crusting, nosebleeds, or whistling when breathing .
• Don't try to pick your nose with your finger. That can make the situation worse.
• There can be many causes; some diseases, drug use, injuries, and rarely even tumors.
• It is essential to see a doctor and get an accurate diagnosis.
• Treatment may include home care, a small button placed in the nose, or surgery. Your doctor will decide what is best for you.
• Although these holes don't heal on their own, they don't always require major treatment. Sometimes, observation is enough.

The most important thing is that if you have any doubts about this, don't be afraid to talk to a doctor. That way, you'll get the help you need.

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