xRead - Nasal Obstruction (September 2024) Full Articles

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the NOSE score. 29 – 56 The reasons justifying the exclusion of 55 studies are reported in Figure 1. Study ’ s general characteristics are summarized in Table I. A total of 2577 patients (males: 65.1%, 95% CI: 59.9 – 70.2; females 34.9%, 95% CI: 29.8 – 40.1) with a mean age of 33.3 years ( n = 1456, 95% CI: 30.4 – 36.2) were included in this meta-analysis. All patients included in the analysis had a diagnosis of nasal septal deviation made with clinical examination along with endoscopy and/or rhinomanometry and/or Computed Tomography. Methodological Quality and Risk of Bias of Included Studies MINORS scores for the included studies are listed in Table II. MINORS criteria are based on a score of 16, with 16 being a perfect score for noncomparative studies. 20 The median score calculated in 28 included studies was 14 (range 8 – 15). The major de fi ciencies were the unbiased assessment of the study endpoint, the follow-up period appropriate for the aim of the study and the prospective calculation of the sample size. Most of the studies did not perform any blinding with regard to collection of NOSE score. Finally, few studies made mention of prospective calculation of sample size. All or nearly all studies had clearly stated aims and scarce loss to follow-up. Further more, given that only studies that used the NOSE score were included, nearly all the studies had endpoints that were appropriate to the study aim.

contribution of each study to the overall Q-test statistic for het erogeneity. The standardized difference of the overall treatment effect is plotted on the vertical axis, showing the in fl uence of each study on the pooled effect size. A meta-regression was per formed using a mixed-effects model to explore the relationship between the follow-up time and the change in NOSE score after surgery. The longest follow-up time was used for studies reporting the outcome at different time points. Analysis of publication bias was performed by visual inspection of the funnel plot and calculating the Egger ’ s regres sion intercept 28 for the 6 months follow-up analysis, which statis tically examines the asymmetry of the funnel plot. All the analyses were performed using the R software for statistical computing (R version 4.0.1; “ meta ” and “ dmetar ” pack ages). Statistical signi fi cance was de fi ned as p <0.05.

RESULTS Search Results and Studies Description

A fl ow chart of the study identi fi cation process is shown in Figure 1. A total of 1075 eligible papers was retrieved from the preliminary search on electronic data bases and from articles ’ references screening. After auto matic duplicates removal and both screening of titles and abstracts, 82 full-text manuscript were assessed for eligi bility. One article was identi fi ed from citation searching. Eventually, 28 articles were included in the qualitative analysis, as conformed to the aforementioned eligibility criteria, and all of them were used to calculate the best evidence regarding septoplasty outcomes evaluated using

Fig. 1. PRISMA 2020 fl ow diagram. [Color fi gure can be viewed in the online issue, which is available at www.laryngoscope.com.]

Laryngoscope 133: December 2023

Alessandri-Bonetti et al.: NOSE Score After Septoplasty 3239