title: Nasal packing after septoplasty: a randomized comparison of packing versus no packing in 88 patients.
abstract: The once-common practice of packing the nose after septoplasty was based on a desire to prevent postoperative complications such as bleeding, septal hematoma, and adhesion formation. However, it was since found that not only is nasal packing ineffective in this regard, it can actually cause these complications. Although the consensus in the world literature is that packing should be avoided, to the best of our knowledge, no truly randomized study has been undertaken in Southwest Asia upon which to justify this recommendation here. Therefore, we conducted a prospective randomized comparison of the incidence of a variety of postoperative signs and symptoms in 88 patients, 15 years of age and older, who did (n = 44) and did not (n = 44) undergo nasal packing following septoplasty. We found that the patients who underwent packing experienced significantly more postoperative pain, headache, epiphora, dysphagia, and sleep disturbance on the night of surgery. Oral and nasal examinations 7 days postoperatively revealed no significant difference between the two groups in the incidence of bleeding, septal hematoma, adhesion formation, and local infection. Finally, the packing group reported a moderate to high level of pain during removal of the packing. Our findings confirm that nasal packing after septoplasty is not only unnecessary, it is actually a source of patient discomfort and other signs and symptoms.
authors.affiliation: Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, Aga Khan University Hospital, Karachi, Pakistan. sohail.awan@aku.edu
authors.forename: Mohammad Sohail
authors.initials: MS
authors.lastname: Awan
authors.forename: Moghira
authors.initials: M
authors.lastname: Iqbal
mesh_terms: D000293:Adolescent; D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001458:Bandages; D019818:Clavulanic Acid / Q000627:therapeutic use; D004844:Epistaxis / Q000517:prevention & control*; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D009300:Nasal Septum / Q000601:surgery*; D010147:Pain Measurement; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011184:Postoperative Period; D011446:Prospective Studies; D012225:Rhinoplasty / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D013630:Tampons, Surgical; D013997:Time Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D019818:Clavulanic Acid; D000658:Amoxicillin