{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T11:50:35Z","timestamp":1773921035010,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,11,20]],"date-time":"2014-11-20T00:00:00Z","timestamp":1416441600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Performance of septoplasty is dependent on objective evidence of nasal septal deviation. Although physical examination including anterior rhinoscopy and endoscopic examination is the gold standard for evaluation of septal deviation, third\u2010party payors\u2019 reviews of septoplasty claims are often made on computed tomography (CT) findings. However, the correlation between radiographic evaluation of septal deviation with physical examination findings is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective, blinded, independent evaluation of septal deviation in 39 consecutive patients from physical examination, including anterior rhinoscopy and endoscopic examination, by an otolaryngologist and radiographic evaluation of sinus CT scan by a neuroradiologist. Four distinct septal locations (nasal valve, cartilaginous, inferior\/maxillary crest and osseous septum) were evaluated on a 4\u2010point scale representing (1) 0% to 25%, (2) &gt;25% to 50%, (3) &gt;50% to 75%, and (4) &gt;75% obstruction. Correlation between physical examination and radiographic evaluations was made by Pearson's correlation and quantitative agreement assessed by Krippendorf's alpha.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Statistically significant correlation was detected between physical examination including nasal endoscopy and radiographic assessment of septal deviation only at the osseous septum (p = 0.007, r = 0.425) with low quantitative agreement (\u03b1 = 0.290). No significant correlation was detected at the cartilaginous septum (p = 0.286, r = 0.175), inferior septum (p = 0.117, r = 0.255), or nasal valve (p = 0.174, r = 0.222). Quantitative agreement at the nasal valve suggested a bias in CT to underestimate physical exam findings (\u03b1 = \u22120.490).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CT is a poor substitute for physical examination, the gold standard, in assessment of septal deviation. Clinical decisions about pursuit of septoplasty or third\u2010party payors\u2019 decisions to approve septoplasty should not be made on radiographic evidence.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21445","type":"journal-article","created":{"date-parts":[[2014,11,20]],"date-time":"2014-11-20T18:22:43Z","timestamp":1416507763000},"page":"258-262","source":"Crossref","is-referenced-by-count":25,"title":["Radiographic evaluation of nasal septal deviation from computed tomography correlates poorly with physical exam findings"],"prefix":"10.1002","volume":"5","author":[{"given":"Ahmad R.","family":"Sedaghat","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Massachusetts Eye and Ear Infirmary  Boston MA"},{"name":"Department of Otology and Laryngology Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Kieff","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Massachusetts Eye and Ear Infirmary  Boston MA"},{"name":"Department of Otology and Laryngology Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regan W.","family":"Bergmark","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Massachusetts Eye and Ear Infirmary  Boston MA"},{"name":"Department of Otology and Laryngology Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary E.","family":"Cunnane","sequence":"additional","affiliation":[{"name":"Department of Radiology Massachusetts Eye and Ear Infirmary  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas Y.","family":"Busaba","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Massachusetts Eye and Ear Infirmary  Boston MA"},{"name":"Department of Otology and Laryngology Harvard Medical School  Boston MA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,11,20]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20777"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2003.12.004"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2007.02.002"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23683"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812463848"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3182902729"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2014.28.4007"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941212100409"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23841"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21055"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21163"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2011.25.3630"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23428"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24269"}],"container-title":["International Forum of Allergy &amp; Rhinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Falr.21445","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.21445","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T13:32:53Z","timestamp":1696599173000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/alr.21445"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11,20]]},"references-count":14,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2015,3]]}},"alternative-id":["10.1002\/alr.21445"],"URL":"https:\/\/doi.org\/10.1002\/alr.21445","archive":["Portico"],"relation":{},"ISSN":["2042-6976","2042-6984"],"issn-type":[{"value":"2042-6976","type":"print"},{"value":"2042-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,11,20]]}}}