title: Do ventilated packs reduce post-operative eustachian tube dysfunction?
abstract: Nasal packing is associated with post-operative Eustachian tube dysfunction in patients undergoing nasal surgical procedures. The effect of cannulated nasal packs which may improve nasopharyngeal ventilation was investigated in a prospective randomized controlled trial. Adult elective patients without tympanometric evidence of pre-operative Eustachian tube dysfunction were recruited. All subjects underwent single or combined intranasal surgical procedures and were randomized to receive either bilateral cannulated or non-cannulated Merocel nasal packs. Middle ear pressures (MEP) were recorded pre-operatively and post-operatively before nasal pack removal. Left and right ear results were amalgamated for analysis and 40 adults, 20 in each group were analysed. There was no difference in pre-operative MEP, -15 dPa (median value) in both groups. Post-operatively the MEP changed in both groups P < 0.0001. There was no significant inter group difference in the post-operative median MEP, -85 dPa in the cannulated and -70 dPa in the control groups, (95% c.i. for the difference in the medians -25-55 dPa). Nasal surgery with post-operative packing leads to an objective reduction in MEP which is not altered by venting the packs.
authors.affiliation: ENT Department, Leicester Royal Infirmary, UK.
authors.forename: N J
authors.initials: NJ
authors.lastname: Morgan
authors.forename: G
authors.initials: G
authors.lastname: Soo
authors.forename: I
authors.initials: I
authors.lastname: Frain
authors.forename: D A
authors.initials: DA
authors.lastname: Nunez
mesh_terms: D000158:Acoustic Impedance Tests; D000328:Adult; D001458:Bandages / Q000009:adverse effects; D002404:Catheterization / Q000295:instrumentation; D004427:Ear Diseases / Q000517:prevention & control; D004432:Ear, Middle / Q000503:physiopathology; D017558:Elective Surgical Procedures; D004867:Equipment Design; D005064:Eustachian Tube / Q000503:physiopathology*; D005260:Female; D005557:Formaldehyde / Q000008:administration & dosage; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D008297:Male; D009666:Nose / Q000601:surgery*; D011142:Polyvinyl Alcohol / Q000008:administration & dosage; D011183:Postoperative Complications / Q000517:prevention & control*; D011312:Pressure; D011446:Prospective Studies; D013630:Tampons, Surgical / Q000009:adverse effects
chemical_list: D006490:Hemostatics; D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; D011142:Polyvinyl Alcohol