Inclusion criteria:

• Adults aged ≥ 18 years with a baseline NOSE score ≥30
• Septal Deflection at baseline visible at naseondoscopy
• Capacity to provide informed written consent and complete the study questionnaires
• Participants are willing and able to provide full written informed consent

 Exclusion criteria:

• Any prior septal surgery
• Systemic inflammatory disease or the use of any current oral steroid treatment within the past 2 weeks
• Granulomatosis with polyangiitis
• Naseondoscopic evidence of unrelated associated pathology e.g. adenoid pad, septal perforation, chronic rhinosinusitis indicated by the prescence of polyposis or pus
• Any history of intranasal recreational drug use within the past 6 months
• Breast feeding, pregnancy or intended pregnancy for duration of involvement in trial
• Bleeding diathesis
• Therapeutic anticoagulation (Warfarin/NOAC therapy)
• Clinically significant contraindication to general anaesthesia
• Patient known to be immuno-compromised
• External bony deformity likely to make a substantial contribution to the nasal obstruction