Critical review of the literature on conventional septoplasty in children

Septoplasty in children has been discussed with much skepticism over the years. Ramifications following pediatric septoplasty, especially its effect on craniofacial growth, have been scrutinized. However, recent studies have ratified septoplasty in children to be a lifesaver. We reviewed the literature to determine the effectiveness and the safety of conventional endonasal septoplasty in children. A literature search using various medical literature databases for the period of 2000 to 2020 was performed over a one-month period (January 2021). Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews of Interventions were followed. A total of seven original clinical research articles were selected based on our objective and selection criteria. All studies were at level of evidence III - nonrandomized and noncomparative prospective and retrospective case series. A total of 485 patients, with age ranging from 4 to 17 years, were included. Surgical outcomes were heterogeneous among these studies. The most common indication for conventional endonasal septoplasty among children in these studies included nasal septal deformity causing nasal obstruction, whereas refractory epistaxis was the indication in one study. No major complications were documented and none of the patients underwent revision surgery. Analysis of these results stipulated that conventional septoplasty was an effective and safe therapeutic approach in treating deviated nasal septum in children. However, the quality of evidence is inadequate to recommend conventional septoplasty in children until a better quality study has been completed.