Pediatric septoplasty impact on nasal breathing and when to consider a revision surgery-A meta-analysis study

• Published in: The Egyptian journal of otolaryngology Vol. 40; no. 1; pp. 133 - 9
• Main Authors: Rabie, Amr Nabil, Begermy, Marwa Mohamed El, Shalma, Ahmed Adel Attia El, Fadel, Michael
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2024; Springer; Springer Nature B.V; SpringerOpen
• Subjects: Airway management; Analysis; Bias; CBCT: Cone-beam computed tomography; Children; English language; Health aspects; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Meta-analysis; Nose; NSD: Nasal septum deviation; OSA: Obstructive sleep apnea; Pediatrics; Quality of life; Review Article; Rhinoplasty; Sensitivity analysis; Software; Surgery; NSD: Nasal septum deviation; OSA: Obstructive sleep apnea; CBCT: Cone-beam computed tomography
• ISSN: 2090-8539; 1012-5574; 2090-8539
• DOI: 10.1186/s43163-024-00666-6

Background Some children with a deviated nasal septum show no symptoms, but up to 30% have breathing problems. Septal deviation is usually caused by microtrauma during delivery, but in severe cases, trauma is the main cause. Many people fail to recognize septal damage after trauma, &children with untreated septal abnormalities often have severe problems. Thus, we can see why symptoms increase with age. Objective Through the available literature, this review seeks to establish the effect of nasal septoplasty among pediatric patients on nasal breathing and the need for revision surgery. Subjects and methods Prospective and retrospective studies published in peer-reviewed journals including clinical trials, cohort studies, cases, and cross-sectional. Results Five studies. 4, 5, 6, 8, 9 151 people assessed NOSE pre- and post-pediatric septoplasty. The pooled mean NOSE score difference between pre- and postoperative evaluations was -50.26 (95% CI, -62.55 to -37.97), showing a substantial decrease. In Saeed et al. (Ann Coll Med Mosul June 45(1):70-79, 2023), mean differences ranged from -71 points (95% CI, -75.41 to -66.59) to -30 points in Lee (2017). Surgicalft benefits were regularly shown. Each year of follow-up did not substantially lower NOSE score improvement by 0.39 (SE = 0.29; P  = 0.17; I 2  = 89.6%) in a meta-regression analysis in children, NOSE score improvement increased by 6.36 per year (SE = 1.14; P  =  < 0.001; I 2  = 34.45%). In meta-regression research on revision rates following pediatric septoplasty, each year of follow-up raised the rate by 0.13 (SE 0.02; P  < 0.001; I 2  = 4.78%). However, revision rates were not significantly associated with each year of pediatric age (coefficient, -0.39; SE 0.22; P  = 0.075; I 2  = 86.25%). Conclusion This comprehensive meta-analysis shows that septoplasty improves nasal airway function and obstruction in children. NOSE Scale disease-specific QOL improved significantly after pediatric septoplasty. According to the meta-regression analysis, each year of follow-up time resulted in a 0.39 drop in NOSE score improvement (SE = 0.29; P  = 0.17; I 2  = 89.6%). Each year of pediatric age increased NOSE score improvement by 6.36.