Effectiveness of septal swell body reduction for patients with nasal airway obstruction: A systemic review and meta-analysis.

Background: The septal swell body (SSB), a distinct anatomical structure located in the anterior nasal septum, has been recognized as a significant contributor to nasal obstruction, impacting airflow dynamics and nasal resistance. This meta-analysis evaluated the impact of septal swell body volume reduction (SSBVR).

Methods: A systematic review of studies from PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases was conducted through October 2024. Outcomes included changes in nasal obstruction scores, cross-sectional area, and nasal airway resistance pre- and post-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 crosssectional area (SMD = -1.05, 95% CI [-1.88; -0.21]) and nasal airway resistance (SMD = -0.67, 95% CI [-0.89; -0.45]), while nasal obstruction scores demonstrated significant improvements over up to 12 months (SMD = 2.54, 95% CI [1.81; 3.26]). The addition of SSBVR to turbinate surgery resulted in greater improvement in nasal obstruction scores (SMD = 0.47, 95% CI [0.24; 0.70]) compared to turbinate surgery alone, though no significant differences were observed in crosssectional area or nasal airway resistance. Subgroup analyses revealed time-dependent improvements in nasal obstruction scores and variability in effectiveness based on treatment modality.

Conclusion: : SSBVR significantly improves nasal obstruction and airflow metrics, with added benefits when combined with turbinate surgery. Further randomized trials are warranted to validate these findings and optimize treatment strategies.