Nasal septal perforations are not rare in the field of otolaryngology at present and the management of those is known to be very difficult. The causes of nasal septal perforations are numerous;submucous resection is most common cause, and the heavy metal exposure is the one of them, too. From May 1988 to August 1989, 73 cases of septal lesions were reviewed among 633 examinee who had worked in plating factory. The results are as follows ; 1) Septal lesions were found in 73 persons among the 633 examinee(11.5%);erosion in 37 persons(5.8%), perforation in 30 persons(4.7%) and ulceration in 6 persons(0.9%). 2) The common symptoms were crust formation, nasal obstruction, rhinorrhea and so on. 3) 69.9 percent of septal lesions were less than 1cm in diameter. 4) Chromium was the most common causative heavy metal and 29 of 30 septal perforations had the history of exposure to chromium(96.7%). 5) 80 percent of septal perforations were in area 2 according to classification by Cottle. 6) The operation was performed in 17 of 30 septal perforations(50.7%), which sizes were less than 1cm in 9 patients, 1-2cm in 7 patients and more than 2cm in 1 patient. 7) Among the operation methods, septal mucoperichondrial flap was used in 10 patients, tragal cartilage graft in 3 patients, labial-buccal flap in 2 patients and conchal cartilage graft in 2 patients. 8) Postoperative results showed complete relief of symptoms in 6 patients, improved symptoms in 4 patients and no improvement in 7 patients.