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Nasal valve compromise (NVC) is a common source of nasal airway obstruction, with multiple effective methods for correction. However, there has been the absence of a gold standard test to diagnose the specific source of NVC. Currently, history and physical exam are key measures for distinguishing the NVC from the other anatomical abnormalities. However, there remain ambiguities and disparities in the clinically effectiveness regarding the nasal endoscopy, physiologic measurements (acoustic rhinometry and rhinomanometry), and anatomical measurement (CT). Ideally, an objective preoperative test would be able to determine the cause for NVC and therefore guide the patient specific surgical strategy. The aim of this study was to make a clinical recommendation to solve these issues in the diagnosis of NVC and we review the methods concerning the various diagnostic tools and NVC.