The effect of merocel nasal packing use on cognitive functions

Year 2020, Volume: 10 Issue: 1, 265 - 270, 25.04.2020

Fatih Arslan , Tuğba Kokulu Arslan

https://doi.org/10.32448/entupdates.659903

Abstract

Objective: It is known that the use of nasal packing has many disadvantages. The aim of this study was to investigate the effects of short-term nasal obstruction due to nasal packing on cognitive functions.
Methods: The study group consisted of 40 patients who had nasal congestion due to unilateral nasal septal devi-ation and for whom septoplasty was planned with a mer-ocel pack to be used as a nasal pack at the end of surgery. All surgeries were performed under local anesthesia us-ing 10 cc of jetocaine ampoule. Brief Symptom Inventory Test (BSI), Visual Analog Scale (VAS), Serial Digit Learning Test (SDL), Stroop Test, Visual Aural Digit Span Test (VADS) and P300 test were used to evaluate cognitive functions, symptoms of concentration difficulties and blunted af-fect both preoperatively and peroperatively before nasal pack removal.
Results: All symptoms showed significant per-opera-tive (with a nasal pack in place) deterioration in all pa-tients (p<0.001) on the VAS. The mean per-operative SDL (16.34±5.77), Stroop Test (26.67±3.39), BSI (22.25±11.95) and VADS (21.13±3.44) scores showed significant deteri-oration compared with mean preoperative Stroop Test (20.06±3.14), SDL (22.38±4.34), VADS (25.86±2.92) and BSI (32.58±12.49) scores (p<0.001). The peroperative and preoperative P300 latency and amplitude values showed a significant difference (p<0.001).
Conclusion: The use of a nasal pack, which closes both nasal passages fully, such as a merocel pack, has negative effects on cognitive functions such as the ability to focus and maintain concentration. 

Keywords

Nasal surgery, tampons, surgical, cognitive function, event-related potentials, p300

References

• 1. Arslan F, Kokulu Arslan T. A Very Important Warning for Septoplasty under Local and Local Anesthesia with Sedation. J Anest & Inten Care Med 2018;7:1-2.
• 2. Şahin C, İmer Aras H. Influence of nasal pack removal on patients’ anxiety after septoplasty. Kulak Burun Bogaz Ihtis Derg 2015;25:266-70.
• 3. Acıoğlu E, Edizer DT, Yiğit Ö, Onur F, Alkan Z. Nasal septal packing: which one? Eur Arch Otorhinolaryngol 2012;269:1777-81.
• 4. Hesham A, Ghali A. Rapid Rhino versus Merocel nasal packs in septal surgery. J Laryngol Otol 2011;125:1244-6.
• 5. Özkırış M, Kapusuz Z, Saydam L. Comparison of nasal packs with transseptal suturing after nasal septal surgery. Am J Otolaryngol 2013;34:308-11.
• 6. Durmaz A. Nasal Septal Chain Suture: a New Suturing Technique. J Craniofac Surg 2017;28:220-4.
• 7. Durmaz A. A Modification to the Nasal Septal Chain Suture Which Improves Its Application. J Craniofac Surg 2018;29:502-5.
• 8. Arslan F, Tasdemir S, Durmaz A, Tosun F. The effect of nasal polyposis related nasal obstruction on cognitive functions. Cogn Neurodyn 2018;12:385-90.
• 9. Dobratz EJ, Park SS. Septoplasty pearls. Otolaryngol Clin N Am 2009;42:527-37.
• 10. Plasencia DP, Falcón JC, Barreiro SB, Bocanegra-Pérez MS, Barrero MV, Macías ÁR. Transeptal suturing - a cost-efficient alternative for nasal packing in septal surgery. Braz J Otorhinolaryngol 2016;82:310-3.
• 11. Cukurova I, Cetinkaya EA, Mercan GC, Demirhan E, Gumussoy M. Retrospective analysis of 697 septoplasty surgery cases: packing versus trans-septal suturing method. Acta Otorhinolaryngol Ital 2012;32:111-4.
• 12. Dubin MR, Pletcher SD. Postoperative packing after septoplasty: is it necessary? Otolaryngol Clin North Am 2009;42:279-85.
• 13. Dalgic A, Is A, Dinc ME, Ulusoy S, Avinçsal MÖ, Kulekci M. The Effects of Nasal Packing and Transseptal Suturing After Septoplasty on Olfactory Function, Patient Comfort, and Mucociliary Clearance. J Craniofac Surg 2016;27:487-90.
• 14. Özbal Koç AE, Türkoğlu Babakurban S, Kibar SS, Büyüklü F. A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation? Kulak BurunBogaz Ihtis Derg 2016;26:152-8.
• 15. Bingöl F, Budak A, Şimşek E, Kılıç K, Bingöl BÖ. Comparison of Early- period Results of Nasal Splint and Merocel Nasal Packs in Septoplasty. Turk Arch Otorhinolaryngol 2017;55:136-9.
• 16. Abu Eta R, Eviatar E, Pitaro J, Gavriel H. Post-turbinectomy nasal packing with Merocel versus glove finger Merocel: A prospective, randomized, controlled trial. Ear Nose Throat J 2018;97:64-8.