[Nasal packing and stenting].
Despite nasal packing is not necessary after functional endoscopic sinus surgery according to modern surgical techniques, nasal packing is a necessary tool in ENT. Therefore the state of the art regarding indications, benefit and risk of nasal packing and stents are given. In endonasal surgery only those conventional nasal packing materials should be used--if necessary--which have a smooth surface and minimize mucosal damage, potential worsening of wound healing and negative impact on patient comfort. Modern FESS implicates modern types of nasal packing, which leave the old concept of performing pressure and occupying space. So called hemostatic/resorbable materials are a first step in this direction. But they are critical, because these materials cause increased synechiae and sometimes foreign body reactions because of incorporation into the mucosa. Occlusion of the nose via simple taping of the nasal entrance is a simple and very effective method to create a moist environment to optimize endonasal wound healing or management of a dry nose. Stenting of the frontal sinus is only recommended if it is not possible to realize a sufficiently wide, physiologically formed and in large areas with mucosa covered frontal sinus outflow tract.
Weber
R K
RK
Leiter der Sektion Nasennebenhöhlen- und Schädelbasischirurgie, Traumatologie, HNO-Klinik, Städtisches Klinikum Karlsruhe. rainer.weber@klinikum-karlsruhe.de
D005549:Foreign-Body Reaction / Q000209:etiology; D006488:Hemostasis, Surgical; D006801:Humans; D015508:Nasal Obstruction / Q000209:etiology / Q000601:surgery*; D010254:Paranasal Sinus Diseases / Q000209:etiology / Q000601:surgery*; D012307:Risk Factors; D015607:Stents; D013630:Tampons, Surgical; D014945:Wound Healing / Q000502:physiology