Singh A, Patel N, Kenyon G, Donaldson G
Department of Otolaryngology-Head & Neck Surgery, Whipps Cross Hospital, London, UK.
J Laryngol Otol. 2006 Nov;120(11):916-20. doi: 10.1017/S0022215106003410. Epub 2006 Oct 12.
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.
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.
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=0.018).
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.
确定任何前瞻性对照试验，以提供鼻中隔手术后鼻气道阻力降低的客观证据，并对现有数据进行荟萃分析。
进行了一项带有数据荟萃分析的系统评价。使用既定的检索策略对文献进行系统评价，以识别采用气道评估客观方法来评估鼻中隔手术益处的论文。气道评估的公认技术包括鼻声反射、主动前鼻测压法和鼻吸气峰流速。根据预先确定的标准纳入论文，这些标准包括1984年鼻测压标准化委员会报告指南中概述的技术标准化。
我们识别出942篇文章，其中13篇为评估鼻中隔手术客观益处的前瞻性研究。这些研究中只有3项符合纳入标准。使用Mantel-Haenszel方法对这些论文进行了荟萃分析，结果表明鼻中隔手术治疗鼻塞后鼻气道阻力总体降低（p=0.018）。
大多数评估鼻中隔手术客观益处的研究不符合鼻测压标准化委员会报告的建议。仅识别出3项前瞻性对照试验，有来自141例病例的汇总数据用于荟萃分析。因此，关于鼻中隔手术后气道功能客观改善所能得出的结论有限。需要更多遵循标准化技术的长期研究来提供更有说服力的数据。
