Our Summary

This research paper is about a study that looked at the effectiveness and safety of two different treatments for people with a deviated nasal septum (DNS), a condition where the thin wall between your nostrils leans to one side, often causing blocked noses.

One treatment is called septoplasty, which is a surgical procedure to straighten the septum. The other treatment is septoplasty along with something called inferior turbinate reduction (ITR), which is a procedure to reduce the size of the nasal structures called turbinates in cases where they have grown bigger to compensate for the DNS.

The researchers searched through multiple databases to find relevant studies. They wanted to see how the two treatments affected the patient’s quality of life and ability to breathe through their nose, and how often there were any side effects or complications.

They found 12 studies that met their criteria, involving a total of 775 participants. These studies followed up with the participants for periods ranging from one month to four years after their treatment.

Based on their analysis of these studies, the researchers concluded that septoplasty with ITR resulted in better relief of nasal obstruction for adults with DNS than septoplasty alone. However, there were more side effects with the combined treatment.

However, the researchers also warned that there were only a few high-quality studies on this topic, so their conclusions should be taken with a pinch of salt.

FAQs

  1. What is the purpose of the systematic review and meta-analysis in this study?
  2. What were the primary outcomes of the study on septoplasty with ITR versus septoplasty alone?
  3. What is the conclusion of the study regarding the efficacy and safety of septoplasty with ITR?

Doctor’s Tip

A helpful tip a doctor might tell a patient about septoplasty is to discuss the possibility of undergoing concurrent inferior turbinate reduction (ITR) during the procedure. Research suggests that adding ITR to septoplasty can improve subjective relief of nasal obstruction in patients with deviated nasal septum (DNS). However, it is important to weigh the potential benefits against the increased risk of adverse events associated with ITR. It is recommended to have a thorough discussion with your surgeon about the potential risks and benefits before making a decision.

Suitable For

Patients with nasal obstruction due to a deviated nasal septum (DNS) are typically recommended septoplasty. In cases where there is accompanying inferior turbinate hypertrophy, additional inferior turbinate reduction (ITR) may also be recommended to further improve nasal obstruction symptoms. This systematic review and meta-analysis found that septoplasty with unilateral reduction of the contralateral inferior turbinate resulted in better subjective relief of nasal obstruction compared to septoplasty alone in adults with DNS. However, it is important to note that the rate of adverse events was higher with ITR, so caution is warranted when considering this additional procedure.

Timeline

Before septoplasty:

  1. Patient experiences symptoms of nasal obstruction, such as difficulty breathing through the nose, nasal congestion, and frequent sinus infections.
  2. Patient may undergo a physical examination and imaging studies, such as a CT scan, to diagnose a deviated nasal septum.
  3. Patient may try conservative treatment options, such as nasal decongestants or nasal steroid sprays, to alleviate symptoms.

After septoplasty:

  1. Patient undergoes septoplasty surgery to correct the deviated nasal septum.
  2. If indicated, patient may also undergo inferior turbinate reduction during the septoplasty procedure.
  3. Patient may experience some pain, swelling, and congestion in the days following surgery.
  4. Over time, patient should experience improved nasal breathing and a reduction in symptoms of nasal obstruction.
  5. Patient may need to follow up with their surgeon for post-operative care and to monitor their healing progress.

What to Ask Your Doctor

  1. What is the purpose of including inferior turbinate reduction (ITR) in my septoplasty procedure?
  2. How will ITR improve my nasal obstruction symptoms compared to septoplasty alone?
  3. What are the potential risks and complications associated with ITR during septoplasty?
  4. How long is the recovery period for septoplasty with ITR compared to septoplasty alone?
  5. Are there any specific post-operative care instructions I should follow after having septoplasty with ITR?
  6. How long can I expect the benefits of septoplasty with ITR to last in improving my nasal obstruction symptoms?
  7. Are there any alternative treatments or procedures that could be considered for my nasal obstruction in addition to septoplasty with ITR?
  8. Will I need to undergo any additional follow-up appointments or treatments after having septoplasty with ITR?
  9. How experienced are you in performing septoplasty with ITR, and what is your success rate with this procedure?
  10. Are there any specific factors in my case that make me a good candidate for septoplasty with ITR?

Reference

Authors: Bin Lajdam G, Alaryani K, Ghaddaf AA, Aljabri A, Halawani A, Alshareef M, Algarni M, Al-Hakami H. Journal: Rhinology. 2022 Dec 1;60(6):411-420. doi: 10.4193/Rhin22.157. PMID: 36150153