Journal archive · Septum, valve and airway · Outcomes, satisfaction and psychology · Complications and management · Anatomy and nasal analysis · 2026
Timing of Nasal Splint Removal After Septoplasty and Its Effects on Postoperative Functional Outcomes and Complications: A Systematic Review and Meta-Analysis
Alansari LS, Almukhlifi A, AlGarni R, Ayub A, Alosaimi Y, Almutairi M, Alnofaie S, Al Khamis W, Alharbi O, Alkhashan N, Albishr J, Alqahtani R, Al-Hakami HA.
In the archive as a landmark paper: the core sweep runs 2011–2026, and this one is here because the history of rhinoplasty rests on it · cited on septoplasty.
Abstract
The optimal timing for intranasal splint removal following septoplasty remains controversial. This systematic review and meta-analysis assessed how splint removal timing affects postoperative pain, nasal function, olfactory performance, and complications. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched PubMed, Google Scholar, and Web of Science (PROSPERO: CRD420251129055). Six studies from Turkey (2011-2024) involving 516 patients were included. Participants were stratified into early (days 1-3), intermediate (days 4-7), and late (>7 days) removal groups. Data were pooled using random-effects models. Results indicated that pain outcomes did not differ between early and intermediate removal, evidenced by a standardized mean difference (SMD) of 0.04 (p=0.80), but pain was significantly lower with late removal compared to intermediate timing (SMD 1.24, p<0.001). Nasal Obstruction Symptom Evaluation (NOSE) scores favored early (SMD -0.57, p=0.037) and intermediate (SMD -0.73, p=0.008) removal over late removal. Olfactory function, assessed using the Connecticut Chemosensory Clinical Research Center (CCCRC) odor test, was impaired with early removal compared to intermediate (SMD -0.56, p=0.039) and late removal (SMD -0.55, p=0.045). While complications showed no significant differences among groups, septal perforation risk was higher with early removal (OR 5.69, 95% CI 0.94-34.44, p=0.059), but this difference did not reach statistical significance.Notably, all included studies were conducted in Turkey, which may limit the generalizability of these findings to other populations and clinical settings. Ultimately, intermediate splint removal (days 4-7) may offer a favorable balance between pain control, functional recovery, and complication prevention following septoplasty.
Abstract as indexed by PubMed; the article is open access (PubMed Central).
Citation
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What the rhinoplasty literature says on this paper's topics, cited line by line to PubMed.
Septum, valve and airway
Every rhinoplasty is a breathing operation whether it intends to be or not: the septum holds the nose up as well as dividing it, and the narrowest part of the whole airway is the internal valve the surgeon is standing over.
Outcomes, satisfaction and psychology
Rhinoplasty is measured with ten different questionnaires, none of which covers both the way the nose looks and the way it breathes, and the best-developed one has no airway questions at all.
Complications and management
Serious complications after rhinoplasty are rare: infection runs under 1% in the two largest single-surgeon series, pooled rib harvests record no pneumothorax, and the bleeding series record no thromboembolism.
Anatomy and nasal analysis
Before any technique is chosen, the nose has to be read: the bone measured, the cartilage counted, the skin assessed, and the result the patient wants agreed on a photograph that is not yet true.
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