This patient has a huge nasal septal perforation involving most of the nasal septum. Both sides of the nose can be seen on either side of the posterior remnant of the nasal septum. The spontaneous development of a nasal septal perforation should always raise the possibility of one of the two potentially fatal nonhealing granulomas of unknown origin the may occur in the nasal cavity. Wegener's granulomatosis and Stuart's malignant nonhealing granuloma. Courtesy of Professor Heinz Stammberger, University of Graz, Austria
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