Copyright \ua9 The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED. Background: The relationship between clinical examination findings and objective nasal patency measures (ONPM) in structural nasal obstruction remains uncertain. Objective: This review aims to explore the relationship between clinical nasal examination findings and ONPM using acoustic rhinometry, PNIF, rhinomanometry and rhinospirometry. Methods Qualitative systematic review using the PRISMA 2020 statement Results: 17 articles were included in the systematic review. Several studies showed a positive relationship between ONPM and clinical nasal examination findings, however evidence in the literature is limited and confined to cohort studies. ONPM using acoustic rhinometry, rhinomanometry and rhinospirometry assessment correlate positively in severe anterior septal deviation but its role in assessing middle/posterior and mild/moderate septal deviation in isolation remains uncertain. There is limited evidence in the literature to assess the relationship between PNIF and clinical examination findings. Conclusion: ONPM has a limited role in supporting clinical examination findings in severe structural nasal obstruction
