The Effect of Nasal Packing or Stenting on Oxidative Stress After Septoplasty

Year 2020, Volume: 7 Issue: 1, 30 - 33, 28.04.2020

Yuce İslamoglu , Aslıhan Ensari Şimsek Ahmet Akkoz Ebubekir Alper Özer Mehmet Ali Babademez OZCAN Erel

Abstract

Septal deviation cause hypoxia which may raise oxidative stress. Nasal packing after septoplasty operation may increase oxidative stress. Different types of nasal packing may effect oxidative stress. Our aim is to investigate effect of nasal packing and nasal stenting after septoplasty operation on oxidative stress and investigate effect of septoplasty operation on oxidative stress. Study is a prospective cohort study. Fifty-five individuals who has nasal septum deviation (NSD) one side total obstruction but no other diseases; ages 18-30; were included for this study. The NSD was diagnosed based on the presence of nasal obstruction complaint, anterior rhinoscopy and nasal endoscopy. Patients randomly divided in to two by the nasal packing type. In group 1 merocel, in group 2 Doyle Silicone Combo splint with airway was used. To investigate oxidative stress levels, preoperatively venous blood was taken. Nasal packing was removed second day of surgery and venous blood was taken just before removal. After 28 days of surgery to investigate effect of septoplasty on oxidative stress, venous sample was taken. We measured thiol/disulfide levels and ischemic modified albumin. For group 1 and 2 preoperative levels compare to nasal packing removal day levels there was significant difference for thiol levels (respectively, p=0.008, p=0.002). Exclude nasal packing type to investigate effect of septoplasty on oxidative stress; preoperative values of thiols compare to 28th day values were significant different (p<0.001). We found nasal packing or stenting type do not have different effect on oxidative stress. Both thiol levels decrease. Unlike the literature; septoplasty has bad effect on thiol levels which is the defensive for oxidation, then thiol levels increases as the time progresses.

Keywords

IMA, Nasal Packing, Oxidative Stress, Septoplasty

Septoplasti Sonrası Nazal Tamponlama ya da Stentlemenin Oksidatif Stres Üzerine Etkisi

Abstract

Septum deviasyonu hipoksiye sebep olabilir ve bu hipoksi oksidatif stresi artırabilir. Septoplasti sonrası nazal tampon kullanmı oksidatif stresi artırabilir. Farklı burun tamponları oksidatif stresi etkileyebilir. Bu çalışmada amacımız septoplasti sonrası kullanılan splint ve tamponun oksidatif stres üzerine etkisini araştırmak ve septoplasti ameliyatının oksidatif stres üzerine etkisini araştırmaktır. Prospektif kohort çalışma planlanmıştır. 18-30 yaş arası tek taraf total obstrüktif olmak şartı ile ek hastalığı olmayan elli beş hasta çalışmaya dahil edilmiştir. Deviasyona nazal tıkanıklık, anterior rinoskopi ve endoskopik muayene ile tanı konmuştur. Hastalar iki gruba ayrılmıştır. Grup 1’e merosel tampon; grup 2’ye doyle nazal splint kullanılmıştır. Oksidatif stres periferik kandan örnekleme yapılarak değerlendirilmiştir. Nazal tampon yada splint ikinci gün alınmış ve hemen arkasına venöz kan örneklemesi yapılmıştır. Ayrıca ameliyat sonrası 28’inci günde de venöz kan örneklemesi yapılmıştır. Thiol/disulfide değerleri ayrıca IMA değerleri çalışılmıştır. Grup 1 ve grup 2 de preoperatif değerler ile tamponların çıktığı gün arasındaki thiol değerleri arasında anlamlı fark bulunmuştur (p=0.008, p=0.002). Her iki grup preoperatif değerleri ile post operatif 28’inci gün thiol değerleri arasından anlamlı fark bulunmuştur. (p<0.001). Nazal tampon ya da stent kullanımı oksidatif stres thiol değerleri üzerine negatif etki yapmakla birlikte gruplar arasında anlamlı fark yoktur. Literatürün aksine septoplasti thiol değerleri üzerine olumsuz etki oluşturmaktadır sonrasında ise bu değer yükselmeye başlamaktadır.

Keywords

IMA, Nazal Tamponlama, Oksidatif Stres, Septoplasti

References

• 1. Roblin DG, Eccles R. What, if any, is the value of septal surgery? Clin Otolaryngol. 2002;27:77–80.
• 2. Hsia JC. Camacho M. Capasso R. Snoring exclusively during nasal breathing: a newly described respiratory pattern during sleep. Sleep Breath. 2014;18(1):159–64.
• 3. Grymer LF. Melsen B. The morphology of the nasal septum in identical twins. Laryngoscope. 1989;99(1):642-6.
• 4. Ahn JC, Kim JW, Lee CH, Rhee CS. Prevalence and risk factors of chronic rhinosinusitus, allergic rhinitis, and nasal septal deviation: Results of the Korean National Health and Nutrition Survey 2008-2012. JAMA Otolaryngol Head Neck Surg. 2016;142(2):162-7.
• 5. Stewart MG, Smith TL, Weaver EM, et al. Outcomes after nasal septoplasty: results from the nasal obstruction septoplasty effectiveness (NOSE) study. Otolaryngol Head Neck Surg. 2004;130(3):283–90.
• 6. Bhattacharyya N. Ambulatory sinus and nasal surgery in the US: demographics and perioperative outcomes. Laryngoscope. 2010;120(3):635–8.
• 7. Samad I, Stevens HE, Maloney A. The efficacy of nasal septal surgery. J Otolaryngol. 1992;21:88-91.
• 8. Weber R, Keerl R, Hochapfel F, Draf W, Toffel PH. Packing in endonasal surgery. Am J Otolaryngol. 2001;22:306-20.
• 9. Nunez DA, Martin FW. An evaluation of post-operative packing in nasal septal surgery. Clin Otolaryngol Allied Sci. 1991;16:549-50.
• 10. Kazkayası M, Dincer C, Sezikli H, Arıkan OK, Caglayan O. The effect of suturing technique and nasal packing on oxidative stress in septoplasty operations Kulak Burun Bogaz Ihtis Derg. 2008;18(1):35-9.
• 11. Weber RK. Nasal packing and stenting. GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery. 2009;8:1-16.
• 12. Ekinci A, Karataş D, Yetiş A, Demir E, Ozcan M. The effects of septoplasty surgery on serum oxidative stress levels Eur Arch Otorhinolaryngol. 2017;274(7):2799-802.
• 13. Ekinci A, Karataş D, Yetiş A, Demir E, Ozcan M. Serum oxidative stress levels in patients with nasal septal deviation. Turk Arch Otorhinolaryngol. 2017;55: 125-8.
• 14. Bozdemir K, Sezgin A, Akkoz A, Erel O, Korkmaz MH. Thiol-disulphide homeostasis in chronic sinusitis without polyposis.Tr-ENT. 2018;28(2):66-70.
• 15. Simsek E, Erel O, Bicer CK, Carlıoglu A. A novel method for determining the relation between nasal polyposis and oxidative stress: the thiol/disulphide homeostasis. Acta Otolaryngol. 2016;136(11):1180-3.
• 16. Cottle MH, Loring RM. Surgery of the nasal septum; new operative procedures and indications. Ann Otol Rhinol Laryngol. 1948;57(3):705-13.
• 17. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem. 2014;47:326-32.
• 18. Bar-Or D, Lau E, Winkler JV. A novel assay for cobalt albumin binding and its potential as a marker for myocardial ischemia-a preliminary report. J Emerg Med. 2000;19(4): 311–5.
• 19. Min HJ, Kim KS. Comment on "The effect of septoplasty surgery on serum oxidative stress levels". Eur Arch Otorhinolaryngol. 2018;275(2):645-6.
• 20. Dogru M, Akoglu H, Kilinckaya MF, Ulfer G. Ischemia-modified albumin levels in children with asthma: a pilot study. Arch Argent Pediatr. 2018;116(4):522-8.
• 21. Alkan Z, Yigit O, Acıoglu E, Araz Server E, Uzun H, Civelek S. The effect of nasal packing on oxidative stress in septoplasty. Operation Turk Arch Otolaryngol. 2013;51:20-2.