title: Computed tomography scan does not correlate with patient experience of nasal obstruction.
abstract: OBJECTIVE
  Third-party payors have begun to demand imaging studies to document septal deviation prior to authorizing septoplasties. This study aims to determine whether septal deviation findings on computed tomography (CT) correlate with symptoms of nasal obstruction as determined by the Nasal Obstruction Symptom Evaluation (NOSE) scale.
  
  
  METHODS
  Prospective and retrospective chart review.
  
  
  METHODS
  Patients 18 years or older undergoing CT scans, which included the nasal septum, were asked to complete a NOSE scale survey and report the laterality of any possible obstruction. Coronal CT images of subjects were graded by two blinded otolaryngologists and two blinded neuroradiologists using a grading system devised by the authors.
  
  
  RESULTS
  Seventy-three subjects met inclusion/exclusion criteria. Interobserver reliability about the degree of septal deviation on CT scans was moderately good to substantial (κ values, 0.43 to 0.72). There was poor correlation between NOSE scores and degree of deviation on CT scans (Kendall's τ, 0.031 to 0.045; P values all >.05). There was poor concordance between the side of symptoms that patients reported and the side that observers thought was most deviated on CT.
  
  
  CONCLUSIONS
  There is little correlation between septal deviation findings on CT scans and symptoms of nasal obstruction. The results do not support a role for CT scans as either a clinically meaningful or necessary test to investigate uncomplicated nasal obstruction.
  
  
  METHODS
  4.
authors.affiliation: Department of Head and Neck Surgery, Loma Linda University, Loma Linda, California.
authors.forename: Farhad
authors.initials: F
authors.lastname: Ardeshirpour
authors.affiliation: Department of Head and Neck Surgery, The Vancouver Clinic, Vancouver, Washington, U.S.A.
authors.forename: Kate E
authors.initials: KE
authors.lastname: McCarn
authors.affiliation: Department of Radiology, Hennepin County Medical Center, Minneapolis, Minnesota.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: McKinney
authors.affiliation: Department of Head and Neck Surgery, Hennepin County Medical Center, Minneapolis, Minnesota.
authors.forename: Rick M
authors.initials: RM
authors.lastname: Odland
authors.affiliation: Department of Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Bevan
authors.initials: B
authors.lastname: Yueh
authors.affiliation: Department of Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Hilger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology*; D009300:Nasal Septum / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D009667:Nose Deformities, Acquired / Q000150:complications* / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Nasal obstruction; computed tomography; nasal reconstruction; nose; radiology; rhinoplasty; septal deviation; septoplasty