{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T03:17:04Z","timestamp":1769915824614,"version":"3.49.0"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T00:00:00Z","timestamp":1623628800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>About 260,000 septoplasties are performed annually in the US to address nasal septal deviation (NSD). Yet, we do not consistently understand what aspects of NSD result in symptoms.<\/jats:p><jats:p><jats:bold>Study Design<\/jats:bold>: Blinded cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two fellowship\u2010trained surgeons blindly reviewed computerized tomography (CTs) of 10 confirmed NSD patients mixed with 36 healthy controls. All patients were correctly identified, however, 24\/36 controls were falsely identified by both surgeons as patients (33.3% specificity), which were grouped as asymptomatic NSD (aNSD), while the remaining controls as non\u2010NSD (healthy). Acoustic rhinometry, rhinomanometry, individual CT\u2010based computational fluid dynamics and nasal sensory testing were applied to address the puzzling questions of why these aNSD had no symptoms and, more fundamentally, what caused symptoms in sNSD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>aNSD reported no nasal symptoms \u2013 Nasal Obstruction Symptom Evaluation score (sNSD: 60.50\u2009\u00b1\u200913.00; aNSD: 5.20\u2009\u00b1\u20095.41; non\u2010NSD: 6.66\u2009\u00b1\u20097.17, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.05); 22\u2010item Sino\u2010Nasal Outcome Test score (sNSD: 32.60\u2009\u00b1\u200914.13; aNSD: 10.04\u2009\u00b1\u200910.10; non\u2010NSD: 9.08\u2009\u00b1\u200912.42, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). No significant differences in measured nasal resistance, minimum cross\u2010sectional area (MCA), degree of septal deviation, and nasal airflow distributions were found between sNSD and aNSD groups. Only three variables differentiate sNSD versus aNSD: anterior averaged heat flux on deviated side, inferior turbinate peak heat flux on non\u2010deviated side, and nasal cool sensitivity measured by menthol lateralization threshold, with no significant differences among these variables found between the two healthy groups (aNSD vs. non\u2010NSD). These variables by themselves or combined can differentiate sNSD from controls with higher specificity than the physicians (ROC area under the curve\u00a0=\u00a00.84 with 70% sensitivity and 91.6% specificity).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study sheds light on the potential mechanisms of NSD symptomatology: distorted nasal cooling due to NSD exacerbated by poorer nasal mucosal sensitivity. It further supports our previous hypothesis that nasal obstruction complaints do not result directly from obstruction, rather from the capacity of our nose to subjectively sense airflow cooling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 132:509\u2013517, 2022<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29673","type":"journal-article","created":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T13:29:35Z","timestamp":1623677375000},"page":"509-517","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Evidence of Nasal Cooling and Sensory Impairments Driving Patient Symptoms With Septal Deviation"],"prefix":"10.1002","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0646-5963","authenticated-orcid":false,"given":"Jennifer","family":"Malik","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Ohio State University  Columbus Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barak M.","family":"Spector","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Ohio State University  Columbus Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7585-4914","authenticated-orcid":false,"given":"Zhenxing","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Ohio State University  Columbus Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Markley","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Ohio State University  Columbus Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Songzhu","family":"Zhao","sequence":"additional","affiliation":[{"name":"Center for Biostatistics The Ohio State University  Columbus OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley A.","family":"Otto","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Ohio State University  Columbus Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander A.","family":"Farag","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Ohio State University  Columbus Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4805-2689","authenticated-orcid":false,"given":"Kai","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery The Ohio State University  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