Nasal septal perforation due to cocain abuse, trauma, nasal surgery produce the symptoms of crust formation, nasal bleeding, secondary infection, whistling on nasal breathing, nasal stuffiness. The conservative treatments of perforation consist of emolliants and humidification. The surgical options for repair of perforation include local intranasal rotation flap and nasolabial cutaneous flap. Reoperation rates of surgically closed nasal septal perforation remain highly unacceptable(30-70%). Since 1970's new methods of septal closure have been introduced by many authors, septal button which made of acryl, plastic and silicon material is one of useful thing. The authors experienced that unknown origined nasal septal perforation was managed by silicon septal button which was button adjusted with the size of perforation.