Final answer:
Septal perforations, aside from being caused by rhinoplasty, can occur due to infections, chronic nasal drug use, autoimmune disorders, trauma, and environmental factors like exposure to industrial chemicals or prolonged use of nasal steroid sprays.
Step-by-step explanation:
Septal perforations are openings that develop in the nasal septum, the structure that separates the two nostrils. While rhinoplasty is one known cause for this condition, there are several other factors that can lead to a septal perforation. Some of these include infections, which can be either bacterial, such as from untreated syphilis, or viral, like herpes. Chronic nasal drug use, especially cocaine, is another common cause, as it can damage the blood vessels in the nasal septum, leading to necrosis and perforation.
Other potential causes are due to autoimmune disorders, such as Wegener's granulomatosis (also known as granulomatosis with polyangiitis), which can cause inflammation and eventual necrosis of the septum. To some extent, trauma or previous surgery to the septum aside from rhinoplasty, can lead to a septal perforation. Environmental factors, like chronic exposure to certain industrial chemicals or prolonged use of nasal steroid sprays, have also been implicated in the development of septal perforations.