Efficacy and safety of endoscopic septoplasty for treating nasal septal deviations compared with conventional septoplasty: A systematic review and meta‐analysis. (6th January 2023)

• Record Type: Journal Article
• Authors: Kim, Do Hyun; Kim, Sung Won; Hwang, Se Hwan
• Is Part Of: Clinical otolaryngology. Volume 48:Number 2(2023)
• Page Start: 108
• Page End: 121
• Publication Date: 2023-01-06
• Subjects: endoscopy -- nasal septum -- post‐operative complications -- safety -- therapeutics; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1111/coa.14021
• Languages: English
• ISSNs: 1749-4478

Abstract

Abstract: Objectives: We assessed the effects and safety of endoscopic septoplasty in patients with nasal septal deviations (NSD), compared with those of conventional septoplasty. Design and Setting: Systematic review and meta‐analysis. Participants: Patients who have undergone various endoscopic septoplasty procedure, such as hemitransfixion incision, incision at the deviated site and Killian incision, and conventional septoplasty. Main Outcome Measures: Six databases were searched up to April 2022. We analysed studies comparing improvements in NSD‐related symptoms and post‐operative complications between endoscopic septoplasty and control (conventional septoplasty) groups. Results: A total of 38 articles with 2733 individuals were included. There were no significant differences in operative time (−0.4354, 95% confidence interval [CI: −1.1670; 0.2962]) or intra‐operative bleeding (−1.3011 [−2.8003; 0.1981]) between the two groups. In the endoscopic septoplasty group, the change in nasal obstruction symptom evaluation score (9.5143 [5.4613; 13.5674] was statistically higher and the incidence of mucosal tearing (0.2766 [0.1889; 0.4049]) was lower. The incidences of full relief from symptoms such as headache (2.1996 [1.6896; 2.8634]), hyposmia (4.4468 [2.6806; 7.3767]), nasal obstruction (5.9871 [4.3292; 8.2800]), post‐nasal drip (4.7241 [3.4086; 6.5472]) and snoring (2.9980 [1.2622; 7.1211]) were significantly higher in the endoscopic septoplasty group. In terms of post‐operative endoscopic findings, epistaxis (0.3043 [0.1969; 0.4703]), hematoma (0.2022 [0.0785; 0.5213]), nasal obstruction 0.3373 [0.1334; 0.8527]), residual posterior septal deviation (0.1562 [0.0921; 0.2650]), septal perforation (0.2286 [0.1069; 0.4889]), residual spur (0.1294 [0.0602; 0.2780]) and synechia (0.2537 [0.1849; 0.3483]) were significantly less common in the endoscopic septoplasty group. Conclusion: Endoscopic septoplasty better relieved NSD‐related symptoms and reduced surgery‐related complications compared to conventional septoplasty.