Nasal septal perforations are usually caused by trauma or surgery, but of course there are other factors such as septal syphilis that cause septal perforations. For the perforation, we generally repair the perforation surgically first. The repair of this perforation is usually for the perforation of the front end of the nasal septum, while the posterior end of the nasal septum does not produce serious damage to the human body or the human nasal function, and some small posterior perforations, which do not produce murmurs, can be left un-repaired. Of course, for the septal perforation caused by syphilis, this type of perforation is mainly for the treatment of the primary disease, in the elimination of the primary disease, or in the case of the primary disease is well controlled, we can also perform surgical repair according to the site of the perforation, of course, the effect of this surgery, may be debatable, such as the primary disease after the surgery and relapse, then the perforation may occur again. Therefore, depending on the situation, the treatment should be carried out accordingly.