Is nasal packing necessary following endoscopic sinus surgery?
OBJECTIVE
To determine the necessity of nasal packing or hemostatic agents or both following endoscopic sinus surgery.


METHODS
Retrospective review of cases in a tertiary care sinus practice at an academic medical center.


METHODS
Records of 165 patients undergoing 169 endoscopic sinus surgeries were reviewed to determine the presence of adjunctive nasal procedures, the use of nasal packing or hemostatic agents or both, blood loss during surgery, and the incidence of bleeding complications following surgery.


RESULTS
The median estimated blood loss during surgery was 50.0 mL (range, 5-1000 mL). In four surgeries (2.4%) hemostatic agents were placed in the nose at the conclusion of surgery, 19 (11.2%) had packing, and 147 (87.0%) had no material left in the nose. No patients had bleeding complications postoperatively. There was a significant decrease in the use of packing or hemostatic agents or both over time.


CONCLUSIONS
Placement of nasal packing or other hemostatic agents or both within the nasal cavity is not necessary in the majority of endoscopic sinus surgeries. The risks, costs, and discomforts associated with these interventions can often be avoided.
Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA. richard.orlandi@hsc.utah.edu
Richard R
RR
Orlandi
Donald C
DC
Lanza
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000503:physiopathology; D002648:Child; D002908:Chronic Disease; D015331:Cohort Studies; D004724:Endoscopy; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006490:Hemostatics / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy*; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D012852:Sinusitis / Q000601:surgery*; D013630:Tampons, Surgical
D006490:Hemostatics