Is there objective evidence that septal surgery improves nasal airflow?

Abstract

Objective: To identify any prospective, controlled trials providing objective evidence of a reduction in nasal airway resistance following nasal septal surgery, and to undertake a meta-analysis of available data.Methods: A systematic review with meta-analysis of data was undertaken. A systematic review of the literature using a defined search strategy was conducted to identify papers that used objective methods of airway assessment to evaluate the benefit of septal surgery. Accepted techniques for objective airway assessment included acoustic rhinometry, active anterior rhinomanometry and peak nasal inspiratory airflow. Papers were included based on pre-defined criteria, which included standardization of techniques as outlined in the guidelines of the 1984 committee report on the standardization of rhinomanometry.Results: We identified 942 articles, of which 13 were prospective studies evaluating the objective benefit of nasal septal surgery. Only three of these studies conformed to the inclusion criteria. A meta-analysis on these papers was performed using the Mantel-Haenszel method, and this demonstrated an overall reduction in nasal airway resistance following septal surgery for nasal obstruction ( p ¼ 0.018).Conclusions: The majority of studies evaluating the objective benefit of septal surgery did not conform to the recommendations of the committee report on the standardization of rhinomanometry. Only three prospective controlled trials, with pooled data from 141 cases, were identified for meta-analysis. The conclusions that can be drawn concerning objective improvement in airway function following nasal septal surgery are therefore limited. More long-term studies, adhering to standardized techniques, are needed to provide more convincing data.

Patient specific CFD models of nasal airflow: Overview of methods and challenges

“…Although septoplasty and turbinectomy were two of the most commonly performed surgical procedures for relieving NAO (Manoukian et al, 1997), the long-term outcomes of such treatments are still not satisfactory (Jesson et al, 1989;Ho et al, 2004). Without any standard criteria, the decision to perform septoplasty was usually based on clinical observations alone (Konstantinidis et al, 2005;Singh et al, 2006). The main reason behind this was the lack of knowledge on the correlation between patient-reported symptoms and objective findings, including fluid mechanical properties.…”

Computed nasal resistance compared with patient-reported symptoms in surgically treated nasal airway passages: A preliminary report

“…2 However, surgical correction of nasal anatomic deformities is not always successful, with reported failure rates as high as 25-50%. [3][4][5][6] These rates may reflect the absence of universally accepted quantitative methods to assess nasal function 7 and the weak correlations between patient-reported symptoms with currently available objective testing. [7][8][9][10] In particular, a number of studies have tried to correlate patientreported symptoms of NAO with clinical measurements of nasal resistance (NR).…”

Lebensqualität vor und nach Septum- und Rhinoplastik

“…In der Vergangenheit ist h ä ufi g der Versuch gemacht worden, die klinisch relevante Verbesserung der Nasenatmung nach Septumchirurgie durch objektive Messungen wie die aktive anteriore Rhinomanometrie, die akustische Rhinometrie oder peak nasal inspiratory fl ow (PNIF) nachzuweisen. Nur drei von 982 Studien erf ü llten die strengen Anforderungen einer Metaanalyse von Singh et al [26] Mit den verwertbaren Daten konnte jedoch eine signifi kante Reduzierung des Nasenwiderstandes nach Septumchirurgie gezeigt werden. Interessante Aspekte deckte eine Arbeit zur seitengetrennten Betrachtung des Operationsergebnisses nach Septumplastik auf [27] .…”