Coke Break

Among the many devastating effects of cocaine is a best-kept secret -- a hole in your septum.

Cocaine can have a dramatic effect of a person's life, ruining health, marriages, careers etc.  As a part of that devastating spectrum, the drug takes its toll on the nose.  By causing intense vasoconstriction, cocaine can badly damage and even destroy the lining of the nose.  Many times, cocaine is cut with irritating substances like Borax or talc, which, in combination with the drug itself, can eat a hole in the septum.

The most common symptoms of perforation of the septum are bleeding, crusting, and whistling.  Long-term use of cocaine can also cause nasal collapse; the bridge of the nose actually sinks in and the nostrils collapse.

Those who are able to kick the cocaine habit may be candidates for elective surgery to correct a perforated septum.  It is a complicated procedure and requires a surgeon who has a great deal of experience in performing internal nose surgery.  Because the hole that's caused is a hole through three nasal layers, each layer must be separately repaired.  The area to be repaired is usually deep in the nose and requires much skill and dexterity to repair.

For patients who are not candidates for surgical repair, a soft pliable rubber-like button can be placed in the hole to help alleviate the troublesome symptoms of bleeding, crusting and whistling.  For those who can tolerate neither surgery nor a button, daily nasal injections with a syrupy salt solution can keep the nose moist and help prevent crusting.

© 2004 AAO-HNS/AAO-HNSF