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Table 2 Summary of Studies Included in our Systematic Review

From: Measurement tools for the diagnosis of nasal septal deviation: a systematic review

Study Study group Control group Diagnostic measure (s) Sensitivity (SN)/Specificity (SP) Results
Choi et al [14] 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)
Mamikoglu et al [31] 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
Tahamiler et al [32] 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
Tahamiler et al [33] 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)
Huygen et al [34] 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
Szucs et al [13] 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
Huang et al [35] 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
Sedaghat et al [36] 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
  1. AR Acoustic Rhinometry, CT computed tomography, MCA Minimal cross sectional area (mMCA: mean minimal cross sectional area, average of right and left nostrils), NAR nasal airway resistance NSSA nasal sound spectral analysis, NPV negative predictive value, OR Odiosoft-Rhino, PNIF peak nasal inspiratory flow, PPV positive predictive value, RMM rhinomanometry, V Total Volume (average of right and left nostrils), VAS Visual analogue score.