Conventional septoplasty complications: A Systematic review and meta-analysis

Purpose: Septoplasty is a commonly performed procedure in otolaryngology. The usual indication is a septal deviation resulting in significant nasal airway obstruction. Although septoplasty is considered a safe technique, some complications can occur. The aim of this investigation was to review and analyze the literature on complications of conventional septoplasty. Methods: A search was run in the PubMed, Scopus, Web of Science databases. To be eligible for this review, a study had to: (i) investigate septoplasty performed on adult patients, (ii) report complications in the short/long period, (iii) be written in English, (iv) be published between January 1, 2017, and May 23, 2022. Results: Ten studies reported quantitative data on post-operative hemorrhage (pooled overall rate [POR] 0.04 [95 % CI, 0.02–0.07]). Twelve investigations were considered for the meta-analysis on septal perforation (POR 0.02 [95 % CI, 0.01–0.04]). Regarding persistent deviation, six studies were eligible (POR 0.13 [95 % CI, 0.07–0.19]). Six papers reported data on post-operative septal hematoma (POR 0.02 [95 % CI, 0.01–0.03]). Finally, six investigations on post-operative synechiae were considered (POR 0.04 [95 % CI, 0.00–0.11]). The funnel plots were substantially symmetrical, ruling out any publication bias for all considered complications, except for synechiae. Conclusions: Calculation of the occurrence rate of the single complication is useful in clinical practice. Proper pre- and post-operative planning, meticulous attention to anatomy and good visualization during surgery are the keys to a safe and effective septoplasty with a very low complication rate.