Septal perforations may arise from a variety of common injuries to the nose. These injuries can compromise blood flow to the nasal septum causing a small hole and eventually leading to a larger perforation. Structural compromise of the nasal septum can in turn lead to a visible indentation in the bridge of the nose known as a saddle nose deformity. Common perforation etiologies include medication abuse, drug use, nose picking and trauma. View article PDF here.