Abstract
We assessed the effects and safety of endoscopic septoplasty in patients with nasal septal deviations (NSD), compared with those of conventional septoplasty. Systematic review and meta-analysis. Patients who have undergone various endoscopic septoplasty procedure, such as hemitransfixion incision, incision at the deviated site and Killian incision, and conventional septoplasty. 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. 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. Endoscopic septoplasty better relieved NSD-related symptoms and reduced surgery-related complications compared to conventional septoplasty.
Published Version
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