(336) Non-surgical Non-pharmacologic Therapy for Nasal Obstruction: A Systematic Review

Introduction: Nasal obstruction is a major quality of life problem that often requires medical or surgical therapy. We set out to characterize the literature on non-surgical, non-pharmacologic treatment for nasal obstruction that did not involve wearable devices or products.

Methods: A systematic review was conducted according to PRISMA guidelines. A comprehensive search of English-language literature from the Pubmed, EMBASE, and Web of Science databases was performed on June 27th, 2022. Studies were excluded that involved surgical procedures, pharmacologic therapy, or medical devices requiring continuous use for benefit. We also excluded studies that did not include outcome measures at least 24 hours after intervention.

Results: Of the 2025 articles initially identified, 5 met criteria for inclusion in the study. The level of evidence ranged from II to IV per PRISMA guidelines. Study heterogeneity prevented meta-analysis. Electromyographic stimulation (EMG) of the nasal muscles, Buteyko breathing techniques, and nasal biofeedback training with EMG demonstrated improvement in nasal obstruction scores and avoidance of surgery. The single study of regular exercise did not demonstrate differences in nasal resistance between endurance athletes and non-athletes.

Conclusions: There is some evidence that EMG training, breathing techniques, and biofeedback training can be used to treat nasal obstruction and avoid surgery for patients. This evidence provides support for a trial of such therapy for patients who are either poor operative candidates or desire non-surgical, non-pharmacologic therapy.