목적: The nasoseptal flap (NSF) has been shown to be a workhorse flap in reconstruction of skull-base defects. We aimed to evaluate the efficiency and complications of NSF in patients with history of septal surgery that had potential risk of tear and decrease of vascularity. 방법:Retrospective chart review of patients who underwent NSF for skullbase reconstruction in tertiary referral center between Feb 2012 and May 2015. Eighteen patients (revision group) who had a history of septoplasty and/or transseptal transsphenoidal approach were included and compared with 88 patients (primary group) without history of septal surgery. 결과:2 small tears occurred during elevate the NSF in revision group and 4 in primary group. (p=0.269) One patient with the 6 lacerated NSF and 9 of the 100 intact NSF experienced postoperative CSF leak. (p=0.457) There was no difference in postoperative CSF leak between revision (5.5%; 1/18) and primary groups (10.2%; 9/88, p=1.000). Donor site complications such as septal perforation were not different between two groups. (revision 2/18 vs. primary 8/88; p= 0.677) 결론:No patients with history of septal surgery failed to elevate NSF. There was no difference of outcomes such as preventing CSF leaks and septal complications between two groups. The history of septal surgery may not affect outcomes of NSF.