The Association between Nasal Septal Deviation, Mean Pulmonary Artery Pressure, and Pulmonary Artery Systolic Pressure – a Scoping Review

Introduction: Significant nasal septal deviation is a common cause of chronic upper airway obstruction, which can have negative cardiopulmonary consequences. Recent studies have evaluated the association between nasal septoplasty and many cardiopulmonary function parameters, including systolic pulmonary artery pressure (SPAP), in patients with significant nasal septal deviation.

Methods: This systematic review and meta-analysis, conducted in accordance with PRISMA guidelines, studies the association between nasal septoplasty and SPAP in patients with nasal septal deviation. The PubMed and OVID databases were searched from January 2010 to December 2023. Studies eligible for inclusion featured patients with significant nasal septal deviation who underwent septoplasty and had preoperative and postoperative SPAP calculated following transthoracic echocardiography; healthy controls were also included. Exclusion criteria included studies featuring patients with other causes of upper airway obstruction and/or other potential etiologies of increased SPAP.

Results: Of 195 identified abstracts, 5 observational studies met criteria and were included in the meta-analysis. A total of 282 unique patients (219 surgical patients, 63 healthy controls) were identified, of whom 189 (67%) were male, with a mean age of 31.8. The preoperative SPAP of surgical patients was significantly higher than their postoperative SPAP (p < 0.05) and that the SPAP of control subjects (p < 0.05). There was no difference between the postoperative SPAP of surgical patients and the SPAP of control subjects.

Conclusions: In select patients with significant untreated nasal septal deviation, surgical treatment is associated with improvements in SPAP, comparable to healthy controls.