AIMS:Middle turbinate lateralisation and adhesion formation (MiTLAF) following endoscopic sinus surgery (FESS) and nasal adhesion (NA) formation following nasal airway obstruction (NAO) surgery are common complications that have not been subject to rigorous scientific review. We aimed to investigate the impact and avoidance of MiTLAF and NA using a series of experimental models, computational fluid dynamics (CFD), prospective clinical experiments, retrospective clinical review and systematic literature review. METHODS: We present a comprehensive summary of the results of seven (7) of our major peer-reviewed publications. RESULTS: We demonstrate that the primary mechanism of nasal patency is activation of the TRPM8 thermoreceptor by mucosal cooling. Through physical and computational experiments we demonstrate that CFD measurements of heat flux correlate highly with patient-reported nasal patency and loss of mucosal cooling, that NA have significant impacts on downstream airflow disruption and loss of patency (particularly for anterior NA), that MiTLAF significantly impacts downstream mucosal heat flux, as well as sinus temperature and humidity. We review and demonstrate the effectiveness of techniques to prevent adhesion formation, including conchopexy and silastic splints. CONCLUSIONS: We demonstrate that Middle turbinate lateralisation and adhesion formation (MiTLAF) following FESS and nasal adhesion (NA) formation following nasal airway surgery cause significant symptoms post-operatively, using validated scientific techniques (computational and observational) and systematic literature review. We describe validated techniques to prevent adhesion formation. Funding: Passe and Williams Foundation Conjoint Grant – Inthavong/Singh. Disclosures: A/Prof Narinder Singh is a consultant for ResMed, Optinose, Nasus, GSK and ENT Technologies and receives grant funding from Microsoft, Passe and Williams Foundation, Ramsay Hospital Research Foundation and CRC-P.