Horizontal Cooler Showdown
 

Most factory CPU coolers blow downwards directly onto the CPU or heat spreader. Horizontal coolers elevate the heatsink radiator fins away from the base, directing airflow either toward the chassis exhaust point or channeled to help cool other motherboard components like the northbridge chipset, memory, or voltage regulators. Also, many of these coolers can be used without a fan. If you don't have a scorching hot CPU and don't plan to do much overclocking, some horizontal coolers can easily transform into silent passively-cooled solutions.

was the ambient noise 44dBA? :)