The Efficacy of Septal Quilting Sutures Versus Nasal Packing in Septoplasty

Abstract

Nasal packing is the classic method adopted by many otolaryngologists to stabilize the nasal septum and decrease the occurrence of postoperative bleeding and septal hematoma after septoplasty. However, because of its associated postoperative morbidity, many surgeons started to adopt alternative methods. This study aimed to assess the outcome and benefits of septal quilting sutures in comparison to nasal packing after septoplasty. A prospective non-randomized comparative interventional study was carried out at two teaching hospitals in Mosul city from January 2020 to January 2021. A total of 60 patients who were candidates for septoplasty, were included in the study. According to the surgeon's preference; 30 patients had placement of septal quilting sutures (group A), and in the other 30 patients nasal packing was performed (group B). Patients were assessed for postoperative morbidity and early outcome in the first 24 h, 1 week and 1 month postoperatively. In the first 24 h after septoplasty, patients in group B had significantly higher levels of nasal/facial pain, headache, sleep disturbance, breathing difficulties and swallowing difficulties compared to group A (p < 0.001). Over the follow up period of 1 month, no significant differences were recorded regarding postoperative bleeding, hematoma, infection, adhesions formation and septal perforation between the two groups (p > 0.05). Septal quilting sutures technique is more favorable in the early period in terms of patient discomfort after septoplasty, better nasal block and nasal/facial pain, the absence of misery on pack removal, with minimal bleeding after surgery.