3-25. SEPTAL ULCERATION/SEPTAL PERFORATION
a. Description. Septal ulceration is an erosion of the mucous membrane of the
nasal septum. The condition may occur in one nostril or in both nostrils. Perforation is
the destruction of the septal cartilage or bone and mucous membrane on both sides of
the septum. Septal ulceration or perforation may result from chronic trauma often
caused by an attempt to remove dry mucus and crusting. Factors conducive to either
septal ulceration or septal perforation include inadequate air humidification; breathing
caustic chemical fumes; and septal deviation causing excessive drying of nasal
b. Signs and Symptoms. Other signs and symptoms include:
Foreign body sensation.
(4) Epistaxis (nosebleed). Epistaxis is usually the first sign. Small
perforations may produce a whistling sound.
c. Treatment. The treatment for this condition is based on bacitracin ointment.
Cases are referred to the Ear, Nose, and Throat clinic on a routine basis.
3-26. SEPTAL HEMATOMA (SEPTAL ABSCESS)
a. Description. Septal hematoma, a collection of pus held in a pocket beneath
the mucous membrane, can occur after trauma to the nose or following septal surgery.
The septum swells and causes nasal obstruction. An infected septal hematoma usually
causes septal abscess.
b. Signs and Symptoms. The most common signs and symptoms of these
Sensation of pressure.
Slightly elevated temperature and dull frontal headache which is present
Hematoma in one nostril may simulate a deviation.