What are the indications for the use of computed tomography before septoplasty?

BACKGROUND Septoplasty is a common procedure performed for the primary indication of nasal airway obstruction. Physical examination with anterior rhinoscopy (AR) and nasal endoscopy (NE) is considered the gold standard for detecting and rating septal deviation. Computed tomography (CT) can also be used to evaluate the nasal septum. Otolaryngologists may use CT in selecting surgical candidates, especially because it is often ordered in the context of chronic rhinosinusitis, whereas insurance companies may request a CT scan for objective evidence to approve septal surgery. Moreover, preoperative CT can be used for further examination of the nasal anatomy and identification of ancillary sinonasal pathologies. However, this modality has additional costs, exposes patients to harmful radiation, and may provide a different assessment of septal deviation than a dynamic three-dimensional physical examination. It is therefore necessary to examine guidelines for its appropriate use before septoplasty.