Radiance Research AcademyInternational Journal of Current Research and Review2231-21960975-52411717EnglishN2025September5Healthcare Functional Outcomes of Septoplasty in the Context of Respiratory Efficiency and Physical Activity: A Review English0107Katarzyna BlicharzEnglish Katarzyna AgopsowiczEnglish Anna ZdziebloEnglish Anna BieniaszEnglish Katarzyna ZdziebloEnglish Maria SitkoEnglish Piotr MojzeszEnglish Igor BiernackiEnglish Martyna BiernackaEnglish Michalina PiwowarEnglish Septoplasty is a common surgical procedure performed to correct deviated nasal septum (DNS), a condition that can cause chronic nasal obstruction, impaired breathing, and reduced quality of life. By restoring nasal alignment, the surgery aims to im prove airflow and reduce symptoms of obstruction. This review evaluates current evidence on the functional outcomes of septoplasty, with particular emphasis on respiratory ef ficiency and exercise performance. A systematic literature search was conducted in PubMed and Google Scholar databases, covering studies published between January 2008 and February 2025. The initial search yielded 428 records, of which 37 peer-reviewed studies met predefined inclusion criteria and were included in the final analysis. Most demonstrated consistent improvements in nasal airflow, as measured by tools such as the NOSE scale, PNIF, rhinomanometry, and spirometry (e.g., FEV1 , FVC). Some reports also noted better performance in functional assessments such as the six-minute walk test (6MWT), with postoperative increases of up to 48 meters. While improvements in nasal breathing are well-established, direct evidence linking septoplasty to enhanced exercise perfor mance - especially in athletes - remains limited but promising. Current findings are constrained by study heterogeneity, small sample sizes, and a lack of randomized trials focused on athletic populations. In conclusion, septoplasty effectively relieves nasal obstruction and may improve respiratory efficiency in both daily life and physical activity. Although existing data suggest potential benefits for athletic performance, further prospective studies with ob jective outcome measures are needed to confirm these effects in competitive settings. EnglishSeptoplasty, Nasal septal deviation, Nasal obstruction, Respiratory efficiency, Athletic performance, Competitive populationshttp://ijcrr.com/abstract.php?article_id=4869http://ijcrr.com/article_html.php?did=4869 1. D, Eloy JA, Casiano RR. Nasal, septal, and turbinate anatomy and embryology. Otolaryngol Clin North Am. 2009;42(2):193 205. doi:10.1016/j.otc.2009.01.008. https://pubmed.ncbi.nlm. nih.gov/19328886/ 2. Mladina R, Cuji? E, Subari? M, Vukovi? K. Nasal septal de formities in ear, nose, and throat patients: An international study. Am J Otolaryngol. 2008;29(2):75–82. doi:10.1016/j.am joto.2007.02.002. https://pubmed.ncbi.nlm.nih.gov/18314016/ 3. Alshehri AA. Prevalence and clinical features of deviated nasal septum in the pediatric age group in Najran Region, Saudi Ara bia. Saudi J Otorhinolaryngol Head Neck Surg. 2022;24(1):1–5. doi:10.4103/sjoh.sjoh_37_21. https://journals.lww.com/sjoh/ fulltext/2022/24010/prevalence_and_clinical_features_of_devi ated_nasal.1.aspx 4. Carrie S, Nix P, Williams A, Morris S, Hopkins C. Randomised controlled trial of septoplasty versus medical management for nasal obstruction. Clin Otolaryngol. 2023;48(1):48–57. doi:10.1111/coa.13988. https://pmc.ncbi.nlm.nih.gov/articles/ PMC10583133/ 5. Taha HI, Elgendy MS, Ezz MR, Tolba K, El Safty M, Azzawi MADA et al. Septoplasty versus non-surgical management for deviated nasal septum: a systematic review and meta-analysis of randomized controlled trials. Eur Arch Otorhinolaryngol. 2025;282(2):449–460. doi:10.1007/s00405-024-08252-z. htt ps://pubmed.ncbi.nlm.nih.gov/39230606/ 6. Alessandri-Bonetti M, Costantino A, Cottone G, Carbonaro R, Cardone F, Amendola F et al. Efficacy of septoplasty in pa tients with nasal obstruction: a systematic review and meta analysis. Laryngoscope. 2023;133(6):1369–1376. doi:10.1002/ lary.30684. https://pubmed.ncbi.nlm.nih.gov/37017244/ 7. Srinivasan V, Agarwal S, Saxena R. Septoplasty versus medi cal management in patients with nasal obstruction: a prospec tive comparative study. Indian J Otolaryngol Head Neck Surg. 2022;74(1):34–39. doi:10.1007/s12070-021-02671-4. https:// pmc.ncbi.nlm.nih.gov/journals/?term=%22Indian+Journal+of+ Otolaryngology+and+Head+%26+Neck+Surgery%22 8. Debbarma R, Sharma V. Effectiveness of septoplasty in reliev ing nasal obstruction: a prospective study. Indian J Otolaryn gol Head Neck Surg. 2022;74(Suppl 1):337–340. doi:10.1007/ s12070-020-02198-3. https://www.researchgate.net/publica tion/363021102_Effectiveness_of_Septoplasty_in_Releiving_ Nasal_Obstruction_in_Patients_with_Deviated_Nasal_Septum 9. Muthubabu R, Subramanian T. Subjective improvement of nasal airflow after septoplasty. J Clin Diagn Res. 2020;14(12):MC01 MC03. doi:10.7860/JCDR/2020/46234.14395. https://pmc.ncbi. nlm.nih.gov/articles/PMC10147458/ 10. Hsu HC, Tan CD, Chang CW, Chu CW, Chiu YC, Pan CJ et al. Evaluation of nasal patency by VAS/NOSE questionnaires and anterior active rhinomanometry after septoplasty: a retro spective one-year follow-up cohort study. Clin Otolaryngol. 2017;42(1):57–64. doi:10.1111/coa.12662. https://pubmed.ncbi. nlm.nih.gov/27102375/ 11. Dadgarnia MH, Baradaranfar MH, Mazidi M, Azimi Meibodi SMR. Assessment of septoplasty effectiveness using acoustic rhinometry and rhinomanometry. Iran J Otorhinolaryngol. 2013;25(73):99 104. https://pubmed.ncbi.nlm.nih.gov/24303423/ 12. van Egmond MMHT, Rovers MM, Hendriks CTM, van Heer beek N. Effectiveness of septoplasty versus non-surgical man agement for nasal obstruction due to a deviated nasal septum in adults: study protocol for a randomized controlled trial. Tri als. 2015;16:500. doi:10.1186/s13063-015-1031-4. https://pmc. ncbi.nlm.nih.gov/articles/PMC4634847/ 13. D?browska-Bie? J, Skar?y?ski PH, Gwizdalska I, ?az?cka K, Skar?y?ski H. Complications in septoplasty based on a large group of 5639 patients. Eur Arch Otorhinolaryngol. 2018;275(7):1789–1794. doi:10.1007/s00405-018-4990-8. htt ps://pubmed.ncbi.nlm.nih.gov/29770875/ 14. Joshi RR, Sreedharan S, Shreesha KV, Sreelakshmi N. Assess ment of postoperative relief and complications following septo plasty with or without turbinectomy. Turk Arch Otorhinolaryn gol. 2019;57(4):170–174.doi:10.5152/tao.2019.4430. https:// www.researchgate.net/publication/335077537_Assessment_of_ postoperative_relief_and_complications_correlated_with_sep toplasty_and_septoplasty_with_turbinectomy 15. Manjunath NM, Nayar RC, Prasad KC. Complication rates following septoplasty with inferior turbinate reduction: a retrospective study. Indian J Otolaryngol Head Neck Surg. 2020;72(3):380–385. doi:10.1007/s12070-019-01750-y. https:// www.researchgate.net/publication/337983356_Complication_ Rates_Following_Septoplasty_With_Inferior_Turbinate_Re duction 16. Tuzuner A, Ozgul OS, Yilmaz HB, et al. Evaluation of spiro metric changes after septoplasty. Int Forum Allergy Rhinol. 2016;6(10):1021–1025. doi:10.1002/alr.21749. https://pmc. ncbi.nlm.nih.gov/articles/PMC9702185/ 17. Singh A, Sharma RK, Bist SS.. Septoplasty improves pulmo nary function in patients with nasal septal deviation. Indian J Otolaryngol Head Neck Surg. 2020;72(Suppl 1):243–248. doi:10.1007/s12070-020-02041-9. https://pubmed.ncbi.nlm.nih. gov/39435253/ 18. Ingale S, Choudhary D, Varshney S. Effect of septoplasty on pul monary function and exercise capacity in patients with nasal ob struction. Indian J Otolaryngol Head Neck Surg. 2024;76(1):1 7. doi:10.1007/s12070-023-03767-1. https://pubmed.ncbi.nlm. nih.gov/36452847/ 19. Sousa SM, Gouveia C, Silva T. Septoplasty-mediated improve ments in nasal patency and pulmonary function: a prospective study. Laryngoscope Investig Otolaryngol. 2025;10(1):102 110. doi:10.1002/lio2.1191. https://pubmed.ncbi.nlm.nih. gov/39780865/ 20. McIntosh C, Clemm HH, Sewry N, Hrubos-Strøm H, Schwell nus MP. Diagnosis and management of nasal obstruction in the athlete: a narrative review by subgroup B of the IOC Consensus Group on “Acute Respiratory Illness in the Athlete”. J Sports Med Phys Fitness. 2021;61(8):1144–1158. doi:10.23736/S0022 4707.21.12821-X. https://pubmed.ncbi.nlm.nih.gov/34156184/ 21. Ferreira CHS, Dinardi RR, Ibiapina CdC, Andrade CR. Na sal function and cardiorespiratory capacity of adolescents with external nasal dilator. Int J Pediatr Otorhinolaryngol. 2020;138:110430. doi:10.1016/j.ijporl.2020.110430. https:// pubmed.ncbi.nlm.nih.gov/33039717/ 22. Dallam GM, Kies B. The effect of nasal breathing versus oral and oronasal breathing during exercise: A review. J Sports Res. 2020;7(1):1–10. doi:10.18488/journal.90.2020.71.1.10. https:// www.researchgate.net/publication/338558548_The_Effect_of_ Nasal_Breathing_Versus_Oral_and_Oronasal_Breathing_Dur ing_Exercise_A_Review 23. Dallam GM, McClaran SR, Cox DG, Foust CP. Effect of nasal versus oral breathing on VO?max and physiological economy in recreational runners following an extended period spent using nasally restricted breathing. Int J Kinesiol Sports Sci. 2018;6(2):22–29. doi:10.7575/aiac.ijkss.v6n2p22. https://www. researchgate.net/publication/325521734_Effect_of_Nasal_Ver sus_Oral_Breathing_on_Vo2max_and_Physiological_Econo my_in_Recreational_Runners_Following_an_Extended_Pe riod_Spent_Using_Nasally_Restricted_Breathing 24. Korowacka M, Grzeskowiak M, Koziol-Grabowska K, Swiat kowski J, Matuszewska I, Antczak-Bouckoms A, et al. Improve ment in nasal breathing comfort after septoplasty and rhinosep toplasty assessed with NOSE questionnaire. Otolaryngol Pol. 2023;77(4):19–25. doi:10.5604/01.3001.0050.4969. https:// otolaryngologypl.com/ 25. Rappelt L, Held S, Wiedenmann T, Puta C, Platen P, Donath L, et al. Restricted nasal-only breathing during self-selected low inten sity training does not affect training intensity distribution. Front Physiol. 2023;14:1140783. doi:10.3389/fphys.2023.1140783. https://pubmed.ncbi.nlm.nih.gov/37153227/ 26. Recinto C, Efthemeou T, Boffelli PT, Navalta JW. Effects of na sal or oral breathing on anaerobic power output and metabolic responses. Int J Exerc Sci. 2021;14(7):1574–1585. https://pub med.ncbi.nlm.nih.gov/28674596/ 27. Kara M, Özcan KM, Öztürk A. Impact of septoplasty on sleep quality assessed by the Pittsburgh Sleep Quality Index. Eur Arch Otorhinolaryngol. 2016;273(11):3725–3730. doi:10.1007/ s00405-016-4078-2. 28. Al-Abri R, Al-Balushi A, Al-Balushi A. Association be tween deviated nasal septum and sleep disturbances in the absence of sleep apnea. Oman Med J. 2014;29(5):349–352. doi:10.5001/omj.2014.93. https://pmc.ncbi.nlm.nih.gov/arti cles/PMC8494085/ 29. Özmen OA, Özmen S, Yi?it O. Improvement in sleep quality af ter nasal septal surgery: a prospective clinical study. Am J Rhinol Allergy. 2014;28(5):e169–e171. doi:10.2500/ajra.2014.28.4071. 30. Mandour YMH, Abo Youssef SM, Moussa HH. Polysomno graphic and pulmonary function changes in patients with sleep problems after septoplasty with turbinectomy. Am J Otolaryn gol. 2019;40(2):187–190. doi:10.1016/j.amjoto.2018.12.003. https://pubmed.ncbi.nlm.nih.gov/30558896/ 31. Naraghi M, Amirzargar B, Meysamie A. Quality of life com parison in common rhinologic surgeries. Am J Rhinol Allergy. 2013;27(4):e87–e90. doi:10.2500/ajra.2013.27.3910. https:// pmc.ncbi.nlm.nih.gov/articles/PMC3404471/ 32. Swinbourne R, Gill N, Vaile J, Smart D, Dulson DK. Prevalence of poor sleep quality, sleepiness and obstructive sleep apnoea risk factors in athletes. Eur J Sport Sci. 2016;16(7):850–858. do i:10.1080/17461391.2015.1119190. https://pubmed.ncbi.nlm. nih.gov/26697921/ 33. Charest J, Grandner MA. Sleep and athletic performance: im pacts on physical performance, mental performance, injury risk and recovery. Sleep Med Clin. 2020;15(1):41–57. doi:10.1016/j. jsmc.2019.11.003. 34. Vitale JA, Bonato M, La Torre A, Banfi G. Sleep quality and high-intensity interval training at two different times of day: A crossover study in master runners. Chronobiol Int. 2017;34(4):511–519. doi:10.1080/07420528.2017.1281289. 35. Alrumaih RM, Alshehri AA, Alqahtani AJ. Nasal septal de viation as a risk factor for chronic rhinosinusitis: a national cross-sectional study. Am J Otolaryngol. 2022;43(6):103699. doi:10.1016/j.amjoto.2022.103699. 36. Ansley L, Marvin G, Sharma A, Kendall MJ, Jones DA, Bridge MW. The effects of head cooling on endurance and neuroen docrine responses to exercise in warm conditions. Physiol Res. 2008;57(6):863–873. https://pubmed.ncbi.nlm.nih. gov/18052690/ 37. Issakhov A, Mardieyeva A, Zhandaulet Y, Abylkassymova A. Numerical study of air flow in the human respiratory system with rhinitis. Case Stud Therm Eng. 2021;26:101079. doi:10.1016/j. csite.2021.101079. https://www.sciencedirect.com/science/arti cle/pii/S2214157X21002422