Clinical Paper
Cosmetic Surgery
Use of nasal packs and intranasal septal splints following septoplasty

https://doi.org/10.1016/j.ijom.2009.05.012Get rights and content

Abstract

The aim of this study was to compare the efficacy of a trans-septum suturing technique with conventional nasal packing and intranasal splints in the classic septoplasty operation. The study is a prospective, randomized clinical trial. 114 patients underwent septoplasty for septal deviation and ensuing nasal obstruction. These patients were divided into two groups: packing (using intranasal septal splints and antibiotic meshes at the end of the operation) and non-packing (using four separate trans-septum through and through horizontal mattress sutures without any mesh or intranasal splint insertion). Randomization was performed using the four block randomization system. Patients who failed the regular follow-up were excluded, and the two groups were compared for postoperative bleeding, hematoma, perforation and synechiae. Patients were asked to record pain levels using a visual analogue scale. The authors found no significant statistical differences between the two groups in the parameters studied, but significantly higher pain levels were noted in the patients in the packing group. The final results confirmed that patients who underwent septoplasty, intranasal packing and septal splint insertion did not benefit more than those who had trans-septum through and through suturing.

Section snippets

Materials and Methods

The authors conducted a randomized clinical trial to evaluate the necessity for nasal packing and septal splint use after septoplasty. From 2002 to 2004, 114 patients enrolled in this study. The patients, for whom septoplasty was considered because of septal deviation and ensuing nasal obstruction, underwent a classic septoplasty operation performed by residents under the supervision of the senior author.

The groups (packing and non-packing) were designed using the four block randomization

Results

After completion of follow-up, 105 patients were eligible for final analysis (9 of 114 patients were excluded because they did not attend follow-up). There were 57 patients in the packing group and 48 patients in the non-packing group. X2 and Student's t-tests were used to obtain information and analyze data. Descriptive approaches were used to evaluate the age and gender distribution.

78 patients were male and 27 female. The mean age was 24.6 years. Of the 105 patients studied, septal deviation

Discussion

All surgery is associated with pain, which may hinder the patient's activities. Today, patients tend to return to their regular life and work soon after any type of surgery. Changing some routine surgical techniques may minimize the patients’ postoperative discomfort.

Intranasal packing is used to prevent nasal hemorrhage, to prevent septal hematoma and to reduce complications after nasal surgery3. Intranasal packing produces some quality-of-life problems for patients. These include problems

Funding

None

Competing Interests

None declared

Ethical Approval

Not required

Acknowledgment

We would like to acknowledge Mrs Susan Kling, assistant director of Bandon public library for her generous assistance in preparing this manuscript.

References (16)

  • A. Arvind Kumar et al.

    Double-blind randomised controlled trial comparing Merocel with Rapid Rhino nasal packs after routine nasal surgery

    Rhinology

    (2003)
  • P. Daneshrad et al.

    Fibrin glue presents complications of septal surgery: Findings in a series of 100 patients

    Ear, Nose & Throat Journal

    (2003)
  • G. Erkhan et al.

    Comparison of suture and nasal packing in rabbit noses

    Laryngoscope

    (2004)
  • B. Guyuron

    Is packing after septorhinoplasty necessary? A randomized study

    Plast reconstr surg

    (1989)
  • I.T. Huang et al.

    Toxic shock syndrome following septoplasty and partial turbinectomy

    J otolaryngol

    (1986)
  • P.F. Jensen et al.

    Episodic nocturnal hypoxia and nasal packs

    Clin otolaryngol

    (1991)
  • I. Kaygusuz et al.

    Bacteriemia in septoplasty and septorhinoplasty

    Rhinology

    (2003)
  • W. Lemmens et al.

    Septal suturing following nasal septoplasty-A valid alternative for nasal packing?

    Acta otorhinolaryngol

    (2001)
There are more references available in the full text version of this article.

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