Effectiveness of Septal Swell Body Reduction for Patients With Nasal Airway Obstruction: A Systematic Review and Meta-Analysis

Abstract

Objectives The septal swell body, a distinct anatomical structure in the anterior nasal septum, is a significant contributor to nasal obstruction and affects airflow dynamics and nasal resistance. This meta-analysis evaluated the impact of septal swell body volume reduction (SSBVR). Methods A systematic review was conducted using PubMed, Scopus, Embase, Web of Science, and Cochrane databases through October 2024. Outcomes included changes in nasal obstruction scores, cross-sectional area, and nasal airway resistance before and after SSBVR. Standardized mean differences (SMDs) were calculated, and the effectiveness of SSBVR combined with turbinate surgery was compared to turbinate surgery alone. Results Seven studies involving 232 patients were analyzed. SSBVR significantly improved cross-sectional area (SMD, –1.05; 95% CI, –1.88 to –0.21) and nasal airway resistance (SMD, –0.67; 95% CI, –0.89 to –0.45). Nasal obstruction scores showed significant improvements up to 12 months (SMD, 2.54; 95% CI, 1.81 to 3.26). When SSBVR was added to turbinate surgery, nasal obstruction scores improved further (SMD, 0.47; 95% CI, 0.24 to 0.70) compared to turbinate surgery alone, though no significant differences were found in cross-sectional area or nasal airway resistance. Subgroup analyses demonstrated time-dependent improvements in nasal obstruction scores and varied effectiveness based on treatment modality. Conclusion SSBVR significantly improves nasal obstruction and airflow metrics, with additional benefits when combined with turbinate surgery. Further randomized trials are warranted to validate these findings and guide optimal treatment strategies.

Keywords

• nasal septum
• nasal obstruction
• nasal cavity
• nasal surgical procedures
• turbinate
• radiofrequency ablation