Table 2 Summary of Studies Included in our Systematic Review

43 patients Ages 18 to 48 years (mean 35 +/-13 yrs)

n = 40 Ages 20 to 50 years (mean 32+/-24 years)

NSSA compared with PNIF and VAS

SN = 86% and SP = 83% for NSSA in septal deviation patients at 2000-4000 Hz interval. SN = 79% and SP = 78% for PNIF

Correlation between PNIF and NSSA for frequency interval 2000- 4000 Hz in deviated patients (r = 0.72, p < 0.01)

24 patients Ages 14 to 67 (median 36)

No control group

AR compared with CT scans MCA measured 2, 4 and 6 cm from the nostril

SN of AR in detecting anterior septal deviations is 57% and SP is 70% when assessing minor septal deviations seen on CT

AR and CT correlate well at if deviation present at a distance of 2 cm from anterior nose (r = 0.73, p < 0.001). Correlation decreases past 4 cm and AR is not accurate beyond 6 cm

61 patients Ages 18 to 66 years (mean 32 +/-11)

No control group

Comparison between AR and VAS using OR at 200- 6000 Hz (MCA 1 measured 2.2 cm from anterior nose)

Not mentioned

Weak correlation but significant results for OR at 2000-4000 Hz and 4000-6000 Hz interval (r = 0.5, p < 0.01) with AR for 2.2 cm from the vestibule for measurement taken ipsilateral to the deviation. Between VAS and OR at 2000-4000 Hz (r = 0.41, p < 0.01) for ipsilateral deviation

n = 68, Ages 18 to 54 years, (mean 32)

n = 61 Ages 17 to 56 years, (mean 34)

Expiratory/inspiratory nasal sound with OR, Compared with VAS and RMM

None mentioned

OR correlates well with VAS/RMM and can be useful tool is measuring nasal patency in 2000-4000 Hz interval (p < 0.0001)

n = 193, no ages given. (Site of septal deviation; vestibule, valve, anterior-superior portion/central and posterior areas)

n = 33, 21-67 years of age

RMM (mean flow at transnasal pressure of 150 Pa) vs rhinoscopic measurement of deviation

None mentioned

RMM is a poor tool for localization of deviation.

Had 80% detection rate for only severe deviations in nasal vestibule and valve

n = 50 Ages 18 to 64, (mean 33) Group 1, n = 8 severe septal deviation anterior nasal cavity up to 2.5 cm from columella, Cottle area I and II Group 2, n = 14 moderate deviation, anterior nasal cavity Cottle area I and II Group 3, n = 12, middle nasal cavity between 2.5 to 4.5 cm from columella, Cottle area IV Group 4, n = 16, posterior nasal cavity, between 4.5 to 8 cm from columella Cottle area V (Figure 2)

n = 15

RMM and AR. Inspiratory and expiratory nasal airway resistance (NAR) at 75 and 150 Pa measured for RMM. MCA and volume of nasal cavity at deviation measured by AR

Both AR and RMM show sensitivity in diagnosis of severe and moderate septal deviation in the anterior part of nasal cavity. Not sensitive enough in middle/ posterior deviations

p <0.05 for MCA, Volume and NAR at 75 and 150 Pa for anterior septal deviation. p > 0.05 for MCA, Volume, and NAR at and 150 Pa for middle and posterior deviations

n = 77 (significant septal deviation); Ages 19-74 yrs, mean age = 39

n = 89 Ages 19-74 yrs, mean age = 39

AR; Mean MCA (anterior 1-5 cm from the anterior nose) Total V (between points at the nostril to 5 cm into the nose)

No sensitivity values given but concluded AR is a sensitive tool to determine structural abnormality

mMCA (p = 0.001) and Total V (p = 0.04) measured on the narrower side was smaller than in the wider part of nasal cavity indicating volume compensation

n = 137 74 males, 63 females mean age = 42 years All had septal deviation

No control group

Nasal endoscopy, anterior rhinoscopy, physical exam

SN = 86.9% and SP = 91.8%

PPV = 93.6% and NPV = 96.4% for septal surgery. Clinical assessment of patients with deviated nasal septum is accurate in predicting them needing medical intervention