Septoplasty in Children: A Systematic Review of Patient Outcomes and Surgical Techniques

Abstract

Background: Paediatric septoplasty has long been a source of controversy, given the central importance of the growing nasal septum for projection of the nasal dorsum and premaxilla. Early literature cautioned on the effects of septoplasty on midface growth. However, untreated paediatric septal defect will stunt midface growth, leading to progressive deformity. We conduct a broad systematic review of outcomes after paediatric septoplasty, and provide a set of surgical recommendations based on our findings. Method(s): A systematic review was carried out according to PRISMA guidelines. Embase, MEDLINE, Web of Science and Google Scholar databases were searched. All studies of patients aged 0-18 who underwent septoplasty were included. Primary outcomes were midface growth, nasal airflow, quality of life and requirement for revision surgery. Surgical techniques were reviewed as a secondary outcome. Result(s): 43 studies met criteria for inclusion. Patients underwent septoplasty alone, or as a component of septorhinoplasty, sinus surgery or repair of a complex congenital anomaly. There was a paucity of evidence on long-term outcomes, including observation through the pubescent growth spurt. Still, the evidence revealed favourable midface development, relief of nasal obstruction and improved quality of life following paediatric septoplasty performed according to sound surgical principles. Conclusion(s): Early septoplasty should be performed in children where indicated for nasal obstruction or promotion of normal development, according to the outlined surgical principles. Further study should focus on long-term midface development after septoplasty.Copyright © 2025