Effects of Functional Rhinoplasty on Nasal Obstruction: A Meta-Analysis.

[BACKGROUND] Functional rhinoplasty (FRP) is used to improve nasal ventilation by correcting problems with the nasal valves. It has not been systematically reviewed on a large scale.

[METHODS] A comprehensive literature search was conducted in the PubMed, EMBASE, and Cochrane Library databases to identify studies evaluating nasal obstruction before and after functional rhinoplasty in patients with nasal valve problems.

[RESULTS] A total of 57 cohorts from 43 studies involving 2024 patients were included in the current meta-analysis. The Nasal Obstruction Symptom Evaluation (NOSE) scores indicated significant improvement in nasal obstruction at the 1-month follow-up (WMD = 38.12; 95% CI, 29.15-47.10; I= 83.6%; P = 0.00), 3-month follow-up (WMD = 48.40; 95% CI, 43.16-53.64; I= 69.1%; P = 0.00), 6-month follow-up (WMD = 44.35; 95% CI, 36.65-52.04; I= 96.6%; P = 0.00), 12-month follow-up (WMD=43.07; 95% CI, 26.56-59.58; I= 97.9%; P = 0.00), and the last follow-up (WMD = 46.90; 95% CI, 43.92-49.88; I= 95.9%; P = 0.00) with respect to the preoperative baseline. The Visual Analogue Scale (VAS) scores indicated a similar trend at the 1-month follow-up (WMD = 4.68; 95% CI, 3.79-5.57; I= 86.8%; P = 0.00), 3-month follow-up (WMD = 4.46; 95% CI, 3.19-5.74; I= 93.3%; P = 0.00), 6-month follow-up (WMD = 4.91; 95% CI, 4.04-5.78; I= 88%; P = 0.00) and last follow-up (WMD = 4.22; 95% CI, 3.12-5.32; I= 97.1%; P = 0.00). Nasal obstruction was obviously relieved through rhinomanometry (SMD=0.56; 95% CI, 0.27-0.84; I= 0.0%; P = 0.00) but not through peak nasal inspiratory flow (PNIF) (SMD=-1.51; 95% CI, -3.10 to 0.07; I= 98.9%; P = 0.09).

[CONCLUSION] FRP may have a positive effect on nasal obstruction caused by nasal valve problems. Broader and well-designed studies are needed to shed more light on the relationships in this area.

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