목적: To analyze to complications associated with the nasoseptal flap procedure. 방법:Retrospective chart review of all patients who underwent nasoseptal flap procedure in our institution during 2008-2013. 결과:A total of 121 patients were identified with a mean follow up time of 10.4 months. Complications associated with this procedure occurred in 33 patients (27%). The majority of complications were related to the septal donor site and included septal perforation, cartilage necrosis and prolonged crusting. Other complications included intraoperative injury to the flap pedicle (n=4) or postoperative CSF leak occurring in the early postoperative period (n=7). Long term quality of life data assessed by the SNOT22 questionnaires did not reveal any difference compared to preoperative scores. 결론:The complication rate with septal flaps is higher than previously described. The majority of the complications occur during long term follow up and are associated with the septal donor site and include septal perforation, prolonged crusting and cartilage necrosis. We hypothesize that the septal vascular supply may become irreversibly compromised during the procedure resulting from either mucosal trauma during passage of the instruments or reduced capillary perfusion associated with the tenting of the nostril. Long term (>1 year) quality of life including sense smell was similar to preoperative assessment. Future prospective studies in larger groups are needed to provide a more accurate analysis of the complications and morbidity associated with the NSF procedure.