{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:22:08Z","timestamp":1790688128651,"version":"4.1.0"},"reference-count":22,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>A deviated nasal septum (DNS) is a frequently observed anatomical abnormality that can lead to nasal airflow obstruction and reduced quality of life. Although septoplasty is widely regarded as the standard surgical approach for symptomatic cases, its effectiveness compared with conservative, nonsurgical treatments remains a subject of ongoing debate. Methods: We performed a systematic literature review up to 26 December 2025, using databases including PubMed, EMBASE, CENTRAL, and Web of Science. The review included only randomized controlled trials (RCTs) involving adult patients with DNS that compared septoplasty to non-surgical treatment strategies. Results: A total of three studies were included in the final analysis. Septoplasty significantly improved NOSE scores at 3 months (MD \u221212.58, 95% CI \u221219.10 to \u22126.06), 6 months (MD \u221228.73, 95% CI \u221233.44 to \u221224.03), and 12 months (MD \u221217.27, 95% CI \u221222.85 to \u221211.69) compared to non-surgical management. Similarly, SNOT-22 scores favored septoplasty at all time points, with the largest benefit observed at 6 months (MD \u22129.64, 95% CI \u221212.66 to \u22126.62). PNIF scores showed improvement in the septoplasty group at 6 months (MD 15.26, 95% CI 4.20 to 26.31), though significance varied over time. Conclusions: In adults with deviated nasal septum, the currently available randomized evidence suggests that septoplasty may provide greater improvement in symptoms and quality of life compared with non-surgical approaches. However, these findings should be interpreted cautiously due to the limited number of included studies and the low-to-moderate certainty of evidence.<\/jats:p>","DOI":"10.3390\/jcm15103930","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T09:12:41Z","timestamp":1779268361000},"page":"3930","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Septoplasty Versus Non-Surgical Treatment for Deviated Nasal Septum: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"given":"Uday","family":"Abd Elhadi","sequence":"first","affiliation":[{"name":"Department of General Medicine, Ziv Medical Center, Safed 24908, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9574-8729","authenticated-orcid":false,"given":"Alaa","family":"Safia","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Ziv Medical Center, Safed 24908, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7344-4962","authenticated-orcid":false,"given":"Muhamed","family":"Masalha","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Emek Medical Center, Afula 1834111, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.4193\/Rhin18.016","article-title":"Septoplasty for nasal obstruction due to a deviated nasal septum in adults: A systematic review","volume":"56","author":"Rovers","year":"2018","journal-title":"Rhinology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/00034894780873S201","article-title":"Deviated nasal septum incidence and etiology","volume":"87","author":"Gray","year":"1978","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1111\/j.1749-4486.2006.01275.x","article-title":"The national comparative audit of surgery for nasal polyposis and chronic rhinosinusitis","volume":"31","author":"Hopkins","year":"2006","journal-title":"Clin. Otolaryngol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.otohns.2003.12.004","article-title":"Outcomes after nasal septoplasty: Results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study","volume":"130","author":"Stewart","year":"2004","journal-title":"Otolaryngol.\u2013Head Neck Surg."},{"key":"ref_5","unstructured":"Thorstensen, W.M. (2014). The Nasal Airway in Asthmatics-from a Structural, Functional and Subjective Perspective. [Doctoral Thesis, Norwegian University of Science and Technology]."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.anl.2005.05.011","article-title":"Long term results following nasal septal surgery: Focus on patients\u2019 satisfaction","volume":"32","author":"Konstantinidis","year":"2005","journal-title":"Auris Nasus Larynx"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"67","DOI":"10.18176\/jiaci.0232","article-title":"Position paper on nasal obstruction: Evaluation and treatment","volume":"28","author":"Valero","year":"2018","journal-title":"J. Investig. Allergol. Clin. Immunol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4193\/Rhin19.410","article-title":"European position paper on diagnostic tools in rhinology","volume":"57","author":"Rimmer","year":"2019","journal-title":"Rhinology"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Van Egmond, M.M., Grutters, J.P., Hannink, G., Van Heerbeek, N., and Rovers, M.M. (2020). Septoplasty versus non-surgical management for nasal obstruction in adults with a deviated septum: Economic evaluation alongside a randomized controlled trial. BMC Med., 18.","DOI":"10.1186\/s12916-020-01562-5"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1177\/0194599812472656","article-title":"Value-based analysis of routine pathologic septal and inferior turbinate specimens","volume":"148","author":"Daniero","year":"2013","journal-title":"Otolaryngol.\u2013Head Neck Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e075445","DOI":"10.1136\/bmj-2023-075445","article-title":"Clinical effectiveness of septoplasty versus medical management for nasal airways obstruction: Multicentre, open label, randomised controlled trial","volume":"383","author":"Carrie","year":"2023","journal-title":"BMJ"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e226","DOI":"10.1055\/s-0041-1730993","article-title":"Comparison of the efficacy of septoplasty with nonsurgical management in improving nasal obstruction in patients with deviated nasal septum\u2013a randomized clinical trial","volume":"26","author":"Srinivasan","year":"2022","journal-title":"Int. Arch. Otorhinolaryngol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/S0140-6736(19)30354-X","article-title":"Septoplasty with or without concurrent turbinate surgery versus non-surgical management for nasal obstruction in adults with a deviated septum: A pragmatic, randomised controlled trial","volume":"394","author":"Rovers","year":"2019","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.amjoto.2009.02.023","article-title":"Outcomes of septoplasty in young adults: The Nasal Obstruction Septoplasty Effectiveness study","volume":"31","author":"Gandomi","year":"2010","journal-title":"Am. J. Otolaryngol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/S0194-5998(00)70244-0","article-title":"Outcomes of septoplasty","volume":"122","author":"Siegel","year":"2000","journal-title":"Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1007\/s00405-024-08937-x","article-title":"Septoplasty versus non-surgical management for deviated nasal septum: A systematic review and meta-analysis of randomized controlled trials","volume":"282","author":"Taha","year":"2025","journal-title":"Eur. Arch. Oto-Rhino-Laryngol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"28855","DOI":"10.1038\/s41598-024-80377-3","article-title":"The benefits of septoplasty for patients with deviated nasal septum and allergic rhinitis: A meta-analysis","volume":"14","author":"Wu","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1186\/s13063-020-4081-1","article-title":"Nasal Airway Obstruction Study (NAIROS): A phase III, open-label, mixed-methods, multicentre randomised controlled trial of septoplasty versus medical management of a septal deviation with nasal obstruction","volume":"21","author":"Rennie","year":"2020","journal-title":"Trials"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Frank-Ito, D.O., and Garcia, G. (2020). Clinical implications of nasal airflow simulations. Clinical and Biomedical Engineering in the Human Nose: A Computational Fluid Dynamics Approach, Springer.","DOI":"10.1007\/978-981-15-6716-2_8"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.anorl.2020.01.024","article-title":"A randomised trial comparing the subjective outcomes following septoplasty with or without inferior turbinoplasty","volume":"137","author":"Samarei","year":"2020","journal-title":"Eur. Ann. Otorhinolaryngol. Head Neck Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"528","DOI":"10.14639\/0392-100X-2072","article-title":"Septoplasty: Is it possible to identify potential \u201cpredictors\u201d of surgical success?","volume":"38","author":"Cantone","year":"2018","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Stacey, D., L\u00e9gar\u00e9, F., Lewis, K., Barry, M.J., Bennett, C.L., Eden, K.B., Holmes-Rovner, M., Llewellyn-Thomas, H., Lyddiatt, A., and Thomson, R. (2017). Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst. Rev., CD001431.","DOI":"10.1002\/14651858.CD001431.pub5"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/10\/3930\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T09:58:32Z","timestamp":1779271112000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/10\/3930"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,20]]},"references-count":22,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["jcm15103930"],"URL":"https:\/\/doi.org\/10.3390\/jcm15103930","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,20]]}}}