The nasal septum is like a flat wall that is made of both cartilage and thin bone covered by a lining or mucosa on each side. The septum can be damaged by trauma, poor circulation, or during a rhinoplasty and septoplasty. This can result in a hole in the septal wall which may cause increased air turbulence during breathing resulting in “dry nose” and/or “nose whistling”. Septal perforations usually do not need to be repaired unless problematic. In this circumstance a mucosal flap from another part of the septum or the adjacent nasal wall is used to “patch” the hole in the septum!