Nasal perforation in bony part seen in
High-Yield Explanation
A. (Syphilis) (144 - Dhingra 4th) (189 - Maqbool 11th)Lupus, tuberculosis and leprosy - causes perforation in the cartilaginous part while syphilis involves the bony part**PERFORATION OF NASAL SEPTUM1. Traumatic perforations - Trauma is the most common cause*a. Surgical (during and after SMR) or accidentalb. Constant habit of nose pickingc. Tight nasal packingd. Repeated cauterization with chemicals or galvanocautrye. Haematoma and abscess formation due to necrosis of the septal cartilage2. Pathologic perforationsa. Septal abscessb. Nasal myiasis, allergic rhinitisc. Rhinolith or neglected foreign body causing pressure necrosisd. Chronic granulomatous conditions like lupus, tuberculosis and leprosy, syphilise. Wegener's granuloma is a midline destructive lesion which may cause total septal destruction**f. Irritants like tobacco or cocaine snuff and fumes such as those of chronic acid and mercuryg. Tumours of the septum eg chondrosarcoma, granuloma.* Perforation of posterior septum is commonly seen in syphilis**Treatment - Inactive small peforation can be surgically closed by plastic flaps - larger perforations are difficult to close.