AlEnazi Abdulaziz, Alshathri Almaha H, Alshathri Aljohara H, Algazlan Aljoud, Alkudsi Nuha, Assiri Hassan, Alarfaj Ahmed
Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Fahd Hospital of the University, Al-Khobar. Imam Abdul Rahman bin Faisal University, Dammam, Saudi Arabia.
College of Medicine, King Saud University, Riyadh, Saudi Arabia.
JPRAS Open. 2023 Dec 23;40:158-169. doi: 10.1016/j.jpra.2023.12.012. eCollection 2024 Jun.
Accurate methods are needed to evaluate the anatomy of the internal nasal valve (INV), yet there is currently no ideal measurement technique. Our systematic review aims to establish a comprehensive INV assessment tool, compare different INV diagnostic tools, and establish the most ideal measurement technique for the evaluation of the INV.
A systematic review and meta-analysis were conducted following the PRISMA guidelines, and the study was recorded in PROSPERO under reference number CRD42023407950. A systematic search was performed in PubMed, MEDLINE, The Cochrane Library (Cochrane Databases of Systematic Reviews), and the Cochrane Register of Controlled Trials (CENTRAL) for studies assessing INV that were conducted between 1996 and 2023.
Of the 421 total database searches, 23 studies were found, covering a total of 974 patients (6 studies assessed the accuracy of different diagnostic methods, with 2 of these studies comparing two different diagnostic modalities, and 17 studies measured INV angle). Based on the STROBE tool for quality appraisal the mean score was 16.92 ± ± 2.29, indicating a moderate quality. When comparing INV angle values from preoperative and postoperative records as obtained from CT readings, results showed no significant differences between the pre- and postoperative values (MD = -1.8, 95% CI, -4.8 to 1.2, = .227).
Acoustic rhinometry has the highest accuracy, followed by rhinomanometry then CT scan then endoscopy. Meta-analysis showed no significant differences between the pre- and postoperative values and a significant heterogeneity in the reported INV angle values across studies.
需要准确的方法来评估鼻内瓣膜（INV）的解剖结构，但目前尚无理想的测量技术。我们的系统评价旨在建立一个全面的INV评估工具，比较不同的INV诊断工具，并确定评估INV的最理想测量技术。
按照PRISMA指南进行系统评价和荟萃分析，该研究在PROSPERO中记录，注册号为CRD42023407950。在PubMed、MEDLINE、Cochrane图书馆（Cochrane系统评价数据库）和Cochrane对照试验注册库（CENTRAL）中进行系统检索，以查找1996年至2023年间进行的评估INV的研究。
在总共421次数据库检索中，发现了23项研究，共涉及974例患者（6项研究评估了不同诊断方法的准确性，其中2项研究比较了两种不同的诊断方式，17项研究测量了INV角度）。根据用于质量评估的STROBE工具，平均得分为16.92±2.29，表明质量中等。比较CT读数获得的术前和术后记录中的INV角度值时，结果显示术前和术后值之间无显著差异（MD = -1.8, 95% CI, -4.8至1.2, = 0.227）。
声反射鼻测量法的准确性最高，其次是鼻阻力测量法，然后是CT扫描，最后是内镜检查。荟萃分析显示术前和术后值之间无显著差异，且各研究报告的INV角度值存在显著异质性。
