A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation?
OBJECTIVE
This study aims to compare pain, bleeding, nasal obstruction, crust and synechia formation, and anesthesia-related morbidity in patients with and without use of nasal packs after septoplasty.


METHODS
A total of 66 patients (32 women, 34 men; mean age 24 years; range 18 to 48 years) who underwent Cottle's septoplasty under general anesthesia were randomly allocated to three groups in this prospective cohort. Telfa nasal packs were used in sutures + telfa group (n=22) and Merocell nasal packs in merocel alone group (n=22). No packs were administered in sutures alone group (n=22). Three groups were compared in terms of nasal obstruction, bleeding, pain, crust and synechia formation, as well as the amount of secretion, the need for oropharyngeal airway, the presence of laryngospasm, and effort for nasal breathing after anesthesia.


RESULTS
The amount of bleeding was higher with lower degree of nasal obstruction in sutures alone group. Pain and secretion were more remarkable in merocel alone group. After the first week, these differences were unable to be differentiated among the groups. There were no differences between three groups with respect to crust and synechia formation two weeks after septal surgery.


CONCLUSIONS
Nasal packs can be more useful in patients who suffer from bleeding-related morbidity, while septoplasty applied without nasal packs can be more suitable in patients with obstructive sleep apnea. The use of nasal packs in septoplasty should be determined on an individualized basis with respect to the characteristics of each patient.
Department of Otolaryngology, Başkent University İstanbul Hospital, 34662 Altunizade, Üsküdar, İstanbul, Turkey. ozbalayca@yahoo.com.
Ayça E
AE
Özbal Koç
Seda
S
Türkoğlu Babakurban
Sermin Sayan
SS
Kibar
Fuat
F
Büyüklü
D000293:Adolescent; D000328:Adult; D001458:Bandages; D004844:Epistaxis / Q000209:etiology; D005260:Female; D005557:Formaldehyde; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000209:etiology; D009300:Nasal Septum / Q000601:surgery; D010147:Pain Measurement; D000070659:Patient Comfort; D011142:Polyvinyl Alcohol; D011446:Prospective Studies; D012225:Rhinoplasty / Q000379:methods*; D013630:Tampons, Surgical; D000267:Tissue Adhesions / Q000209:etiology; D055815:Young Adult
D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; D011142:Polyvinyl Alcohol