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Abstract

Deviated nasal septum (DNS) is a frequent cause of nasal obstruction and is commonly treated through submucous resection (SMR). Although effective, SMR carries a risk of septal perforation, which can lead to long-term morbidity. Objectives: To determine the frequency of septal perforation following submucous resection (SMR) of the nasal septum using the tunnel-in technique. Methods: This descriptive observational study was conducted at the Department of ENT, Lady Reading Hospital, Peshawar, from September 2024 to February 2025. A total of 203 patients aged 18–60 years undergoing SMR for symptomatic DNS were enrolled through consecutive non-probability sampling. Patients with prior nasal surgery, trauma, or coexisting nasal pathology were excluded. All surgeries were performed by ENT consultants using a standardized technique. Septal perforation was assessed via endoscopy on the 10th postoperative day. Results: Out of 203 patients, 43 (21.2%) developed septal perforation. The mean age was 38.96 ± 12.74 years; the mean disease duration was 19.52 ± 10.46 months. Perforation showed a significant association with gender (p=0.005) and age group (p=0.025), while no significant link was found with the side of deviation or disease duration. Conclusions: Septal perforation was a relatively common postoperative complication of SMR, with higher occurrence in females and older individuals. Careful patient selection and surgical precision are key to reducing risk.