Kim Do Hyun, Kim Sung Won, Hwang Se Hwan
Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Clin Otolaryngol. 2023 Mar;48(2):108-121. doi: 10.1111/coa.14021. Epub 2023 Jan 6.
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.
我们评估了鼻中隔偏曲（NSD）患者行内镜下鼻中隔成形术的效果和安全性，并与传统鼻中隔成形术进行比较。
系统评价和荟萃分析。
接受过各种内镜下鼻中隔成形术（如半贯穿切口、偏曲部位切口和基利安切口）以及传统鼻中隔成形术的患者。
检索截至2022年4月的六个数据库。我们分析了比较内镜下鼻中隔成形术组与对照组（传统鼻中隔成形术）之间NSD相关症状改善情况及术后并发症的研究。
共纳入38篇文章，涉及2733例个体。两组在手术时间（-0.4354，95%置信区间[CI：-1.1670；0.2962]）或术中出血（-1.3011[-2.8003；0.1981]）方面无显著差异。在内镜下鼻中隔成形术组，鼻阻塞症状评估评分的变化（9.5143[5.4613；13.5674]）在统计学上更高，黏膜撕裂的发生率（0.2766[0.1889；0.4049]）更低。内镜下鼻中隔成形术组头痛（2.1996[1.6896；2.8634]）、嗅觉减退（4.4468[2.6806；7.3767]）、鼻阻塞（5.9871[4.3292；8.2800]）、鼻后滴漏（4.7241[3.4086；6.5472]）和打鼾（2.9980[1.2622；7.1211]）等症状完全缓解的发生率显著更高。在术后内镜检查结果方面，鼻出血（0.3043[0.1969；0.4703]）、血肿（0.2022[0.0785；0.5213]）、鼻阻塞（0.3373[0.1334；0.8527]）、残余后鼻中隔偏曲（0.1562[0.0921；0.2650]）、鼻中隔穿孔（0.2286[0.1069；0.4889]）、残余棘突（0.1294[0.0602；0.2780]）和粘连（0.2537[0.1849；0.3483]）在内镜下鼻中隔成形术组明显较少见。
与传统鼻中隔成形术相比，内镜下鼻中隔成形术能更好地缓解NSD相关症状并减少手术相关并发症。
