Inclusion Criteria:  Age ≥ 18 Patients from all ethnic and geographic backgrounds within the Stanford Sinus Center with symptomatic NSD Primary patients with NSD without past septum surgery Patients who have failed maximum medical therapy Patients whose symptoms, examination and/or imaging findings are sufficiently severe as to warrant septoplasty as determined by the treating surgeon  Exclusion Criteria:  Age < 18 Recent surgery of any kind (<1 month) Inpatients Previous nasal septum surgery