Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Division of Otolaryngology-Head and Neck Surgery, University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada.
Laryngoscope. 2023 Nov;133(11):2837-2845. doi: 10.1002/lary.30651. Epub 2023 Mar 10.
A deviated nasal septum (DNS) can result in an anatomical obstruction and impact lung function through prolonged suboptimal inspiration. Given the improvements in respiration reported by patients following septoplasty or septorhinoplasty (with or without inferior turbinate reduction), our study investigated the effect of these procedures on pulmonary function through a systematic review and meta-analysis.
Medline, Embase, Cochrane Databases, Web of Science, and Google Scholar.
The review was registered with PROSPERO [CRD42022316309]. The study population was composed of adult patients (18-65) who were symptomatic with confirmed DNS. Extracted outcomes (pre-operative versus postoperative) included the six-minute walk test (6MWT) and pulmonary function tests (FEV1, FVC, FEV1/FVC, FEF25-75, PEF). Meta-analyses were performed using a random-effects model.
Three studies included measures of the 6MWT in meters and all three found a statistically significant increase in the distance walked after surgery with a mean difference of 62.40 m (95% CI 24.79-100.00). Statistically significant improvements in PFT outcomes were observed with a standard mean difference of 0.72 for FEV1 (95% CI 0.31-1.13), 0.63 for FVC (95% CI 0.26-1.00), and 0.64 for PEF (95% CI 0.47-0.82). Of the twelve studies which measured PFT outcomes, six showed statistically significant improvements, three studies showed mixed results, and three studies found no difference in PFT outcomes between pre-and post-surgery testing.
The present study suggests that pulmonary function does improve after nasal surgery for DNS, but the high heterogeneity observed in the meta-analyses indicates that the evidence supporting this conclusion is low. Laryngoscope, 133:2837-2845, 2023.
鼻中隔偏曲（DNS）可导致解剖学阻塞，并通过长时间的次优吸气影响肺功能。鉴于鼻中隔成形术或鼻中隔成形术（伴或不伴下鼻甲缩小术）后患者报告的呼吸改善，我们通过系统评价和荟萃分析研究了这些手术对肺功能的影响。
Medline、Embase、Cochrane 数据库、Web of Science 和 Google Scholar。
该研究已在 PROSPERO [CRD42022316309] 上注册。研究人群由有症状的成人患者（18-65 岁）组成，这些患者确诊为 DNS。提取的结果（术前与术后）包括 6 分钟步行测试（6MWT）和肺功能测试（FEV1、FVC、FEV1/FVC、FEF25-75、PEF）。使用随机效应模型进行荟萃分析。
三项研究包括 6MWT 米数的测量，所有三项研究均发现手术后行走距离有统计学显著增加，平均差异为 62.40 米（95%CI 24.79-100.00）。还观察到 PFT 结果有统计学显著改善，FEV1 的标准均数差为 0.72（95%CI 0.31-1.13），FVC 为 0.63（95%CI 0.26-1.00），PEF 为 0.64（95%CI 0.47-0.82）。在测量 PFT 结果的十二项研究中，有六项显示出统计学显著改善，三项研究显示出混合结果，三项研究发现术前和术后测试之间的 PFT 结果没有差异。
本研究表明，DNS 鼻手术后肺功能确实有所改善，但荟萃分析中观察到的高度异质性表明，支持这一结论的证据水平较低。喉镜，133:2837-2845，2023。
