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鼻中隔成形术后经房间隔缝合与鼻腔内夹板比较的有效性和安全性:系统评价和荟萃分析。

Comparison on the Effectiveness and Safety of Transseptal Suturing Versus Intranasal Splints After Septoplasty: A Systematic Review and Meta-analysis.

机构信息

Otorhinolaryngology - Head and Neck Surgery, Security Forces Hospital, Riyadh, Saudi Arabia.

College of Medicine, King Saud University, Riyadh, Saudi Arabia.

出版信息

Aesthetic Plast Surg. 2024 Nov;48(21):4323-4332. doi: 10.1007/s00266-024-04066-2. Epub 2024 May 20.

DOI:10.1007/s00266-024-04066-2
PMID:38767656
Abstract

BACKGROUND

The application of transseptal suturing as an alternative to intranasal splints in preventing postoperative complications, such as synechia, and maintaining nasal septal stability following Septoplasty, remains controversial. This meta-analysis aims to systematically compare the effectiveness and safety of transseptal suturing with intranasal splints after Septoplasty.

METHODS

A comprehensive systematic literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. The review included randomized clinical trials (RCTs) identified through a database search in July 2023, comparing postoperative complications following Septoplasty with the transseptal suturing technique versus intranasal splints.

RESULTS

Eight published RCTs involving 570 participants were included in the meta-analysis. The analysis revealed no significant difference between the transseptal suturing and intranasal splint techniques following Septoplasty in postoperative complications, including postoperative hemorrhage, synechia, septal hematoma, septal perforation, local infection, crusting, and residual septal deviation.

CONCLUSIONS

Transseptal suturing can be applied following Septoplasty as an alternative to intranasal splints without increasing the rate of postoperative complications.

LEVEL OF EVIDENCE I

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

摘要

背景

经鼻中隔缝合作为预防鼻中隔成形术后粘连等并发症和维持鼻中隔稳定性的替代方法,其应用仍存在争议。本荟萃分析旨在系统比较鼻中隔成形术后应用经鼻中隔缝合与鼻腔内夹板的效果和安全性。

方法

根据系统评价和荟萃分析的首选报告项目(PRISMA)指南进行全面的系统文献回顾。该综述包括 2023 年 7 月通过数据库检索确定的比较鼻中隔成形术后经鼻中隔缝合技术与鼻腔内夹板的随机临床试验(RCT)。

结果

纳入的荟萃分析包括 8 项已发表的 RCT,涉及 570 名参与者。分析显示,鼻中隔成形术后经鼻中隔缝合与鼻腔内夹板技术在术后并发症方面无显著差异,包括术后出血、粘连、鼻中隔血肿、鼻中隔穿孔、局部感染、结痂和残余鼻中隔偏曲。

结论

鼻中隔成形术后可应用经鼻中隔缝合替代鼻腔内夹板,而不会增加术后并发症的发生率。

证据水平 I:本刊要求作者为每篇文章分配一个证据水平。有关这些循证医学评级的更详细描述,请参考目录或在线作者指南 www.springer.com/00266。

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Efficacy of nasal septal splints for preventing complications after septoplasty: A meta-analysis.鼻中隔夹板预防鼻中隔成形术后并发症的疗效:一项荟萃分析。
Am J Otolaryngol. 2021 May-Jun;42(3):102389. doi: 10.1016/j.amjoto.2020.102389. Epub 2020 Jan 3.
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Nasal silicone splints and quilting sutures using a septum stitch device following septoplasty: a prospective comparative study.鼻中隔成形术后使用鼻中隔缝线装置进行鼻腔硅酮夹板和绗缝缝合:一项前瞻性对照研究。
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Comparison of totally occlusive nasal pack, internal nasal splint, and transseptal suture technique after septoplasty in terms of immediate respiratory distress related to anesthesia and surgical complications.鼻中隔成形术后完全闭塞性鼻腔填塞、鼻内夹板及鼻中隔缝合技术在与麻醉相关的即刻呼吸窘迫及手术并发症方面的比较。
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