The above case demonstrates a 45-year-old woman that came to see Dr. Mourad who developed a hole in her septum secondary to cocaine use. The photo on the left is a photo into the left nostril that demonstrates the 1.2 cm perforation which is located in the front portion of the septum. Her symptoms included noisy breathing, frequent nasal crusting, and bleeding. She also suffered from frequent sinus infections. The picture on the right demonstrates an intraoperative view of the repaired perforation, immediately after the repair. This perforation was repaired using a left-sided local flap (link to local flap). The technique used was an Anterior Ethmoid Artery Pedicled Flap. This technique uses rearrangement of tissue within the nasal cavity to close the hole in the septum. She has mild swelling in the area that will resolve with time.