I know I have a perforation—I want to know what it could be that there is something that slides back and forth within the perforation. I feel it when I am clearing my nose with a Q-tip because my nose is dry and unable to blow my nose. I have sjögren's syndrome, and it is difficult clearing my nose, and I know I must have caused damage. I also used steroid sprays because of chronic congestion and the need to clear my nose because I have to use a bi-pap machine for chronic obstructive apnea.