목적: Tinnitus is a condition where sound is perceived in the ear or head when no external sound stimulation is present. There has been no study on the correlation between nasal septal deviation (SD) and tinnitus using large-scale real-world data. Our study commenced with the assumption that tinnitus and SD may be related. We investigated this using a 9-year large-scale cohort study. 방법:The SD group was selected from 1 million individuals randomly extracted from the National Health Insurance Service database. The non-SD group was obtained through Propensity Score matching considering several variables. The primary end point was tinnitus diagnosis. 결과:The study (SD) group included 10790 individuals and the non-SD group (control group) included 21580 individuals. The overall hazard ratio (HR) for tinnitus in the SD group was 1.74 (95% CI: 1.62–1.89). In subgroup analysis, the HR was 0.73 (95% CI: 0.68–0.79) for tinnitus in the group of male individuals, 1.12 (95% CI: 1.04–1.21) in the group with high economic status, 0.81 (95% CI: 0.75–0.89) in the group living in a metropolitan area, and 0.45 (95% CI: 0.42–0.49) in the group with younger age (<50 years). In the SD group, the HR for tinnitus after septoplasty was significantly decreased as 0.75 (95% CI: 0.63–0.90). 결론:From long-term follow-up, the prevalence of tinnitus was 1.74 times higher in the SD group compared with the control group. This phenomenon decreased significantly after septoplasty.