Attitudes among ENT surgeons towards the use of nasal tamponade after nasal septal surgery

Year 2007, Volume: 17 Issue: 6, 301 - 306, 24.11.2007

Alper Nabi Erkan Özcan Çakmak

Abstract

Objectives: We investigated the use of nasal tampon­ ade after nasal septal surgery among ENT surgeons.Materials and Methods: An 11-item questionnaire was prepared to investigate the use of nasal tampon­ ade in nasal operations and administered to partici- pating physicians at a meeting held in Adana, Turkey, on November 4, 2006, titled “Başkent ENT Days and Çukurova ENT Association Meeting”. During the meet­ ing 72 surgeons 13 females, 59 males; mean age 39 years; range 26 to 64 years responded to the ques- tionnaire.Results: Findings shovved that 61 surgeons 84.7% used nasal tamponade after nasal operations, while 11 surgeons 15.3% preferred suturing. The most common reason for tampon use was to prevent sep­ tal hematoma and edema 63.9% . Most of the sur­ geons 60.5% used nasal tamponade for two days.While ali the participants used antibiotic treatment along with nasal tamponade, 98.3% also prescribed an analgesic, and 62.2% prescribed an antihista- minic. At the time of removing the nasal tampon, 13.2% n=8 of the surgeons used a drug to prevent pain. The most common problem encountered dur­ ing removal was pain 54% .Conclusion: The use of nasal tamponade depends on the experience and preference of surgeons.

Keywords

Epistaxis/prevention & control, nasal septum/ surgery, nose/surgery, guestionnaires, tampons, surgical

Nazal septal cerrahi sonrasnda nazal tampon kullanm konusunda KBB hekimlerinin yaklam

Abstract

Amaç: KBB hekimleri arasında nazal septal cerrahi sonras nda nazal tampon kullan m ara t r ld .Gereç ve Yöntemler: Burun ameliyatlar nda nazal tampon kullan m n ara t rmak için 11 sorudan olu an bir anket formu haz rland . Anket, 4 Kas m 2006 tarihinde Adana da yap lan Ba kent KBB Günleri ve Çukurova KBB Derne i Toplant s nda kat l mc hekimlere da t ld . Toplant lar sonunda anket formlar toplanarak de erlendirildi. Yetmiş iki hekimin anketi yan tlad görüldü. Bulgular: Burun ameliyatlar ndan sonra nazal tampon kullanan hekim say s 61 %84.7 , sütürasyon yapan hekim say s 11 %15.3 olarak bulundu. En s k tampon kullan m nedeni septal hematom ve ödemi önlemek %63.9 olarak bildirildi. Nazal tamponun kal süresini hekimlerin ço unlu u %60.5 iki gün olarak bildirdi. Hekimlerin hepsi nazal tampon kullan lan hastalara antibiyotik tedavisi verirken, %.98.3 ü a r kesici de verdi ini belirtti. Hekimlerin %62.2 si ayr ca antihistaminik verdi ini bildirdi. Nazal tampon ç kar l rken a r y önlemek amac yla ilaç tedavisi veren hekim oran %13.2 n=8 idi. Tampon ç kar l rken en s k kar la lan sorun %54 oran yla a r idi. Sonuç: Nazal tampon kullan m nda cerrah n deneyimleri ve tercihleri ön plana çıkmaktadır

Keywords

Burun kanamas /koruma ve kontrol, nazal septum/cerrahi, burun/cererahi, anket, tampon, cerrahi

References

• Weber R, Hochapfel F, Draf W. Packing and stents in endonasal surgery. Rhinology 2000;38:49-62.
• Hayward PJ, Mackay IS. Fibrin glue in nasal septal surgery. J Laryngol Otol 1987;101:133-8.
• Lemmens W, Lemkens P. Septal suturing following nasal septoplasty, a valid alternative for nasal pack- ing? Acta Otorhinolaryngol Belg 2001;55:215-21.
• Ogretmenoglu O, Yilmaz T, Rahimi K, Aksoyek S. The effect on arterial blood gases and heart rate of bilat- eral nasal packing. Eur Arch Otorhinolaryngol 2002; 259:63-6.
• Garth RJ, Brightwell AP. A comparison of packing materials used in nasal surgery. J Laryngol Otol 1994; 108:564-6.
• Titiz A, Y lmaz YF, Çelik G, Özcan M, Ünal A. Septoplasti sonras nazal tampon olarak kullan lan Merocel ve eldiven parma uygulamalar n n klinik olarak kar la t r lmas . KBB ve BBC Dergisi 2005;13:69-72.
• von Schoenberg M, Robinson P, Ryan R. Nasal packing after routine nasal surgery-is it justified? J Laryngol Otol 1993;107:902-5.
• von Schoenberg M, Robinson P, Ryan R. The morbid- ity from nasal splints in 105 patients. Clin Otolaryngol Allied Sci 1992;17:528-30.
• Daneshrad P, Chin GY, Rice DH. Fibrin glue prevents complications of septal surgery: findings in a series of 100 patients. Ear Nose Throat J 2003;82:196-7.
• Sessions RB. Membrane approximation by continuous mattress sutures following septoplasty. Laryngoscope 1984;94:702-3.
• Nunez DA, Martin FW. An evaluation of post-opera- tive packing in nasal septal surgery. Clin Otolaryngol Allied Sci 1991;16:549-50.
• Tarhan E, Çakmak Ö, Özgirgin N. Nazal septal cerrahi sonras splint, tampon ve sütürasyon uygulamalar n n kar la t r lmas . KBB ve BBC Dergisi 2005;13:20-4.
• Yavuzer R, Jackson IT. Nasal packing in rhinoplas- ty and septorhinoplasty: it is wiser to avoid. Plast Reconstr Surg 1999;103:1081-2.
• Lubianca-Neto JF, Sant’anna GD, Mauri M, Arrarte JL, Brinckmann CA. Evaluation of time of nasal packing after nasal surgery: a randomized trial. Otolaryngol Head Neck Surg 2000;122:899-901.
• Erdem T. Septoplasti ve septorinoplasti sonras kullan lan nazal tamponlar ve stentler. KBB ve BBC’de Güncel Yakla m 2006;2:46-52.
• Rechtweg JS, Paolini RV, Belmont MJ, Wax MK. Postoperative antibiotic use of septoplasty: a survey of practice habits of the membership of the American Rhinologic Society. Am J Rhinol 2001;15:315-20.
• Caniello M, Passerotti GH, Goto EY, Voegels RL, Butugan O. Antibiotics in septoplasty: is it necessary? Rev Bras Otorrinolaringol 2005;71:734-8.
• Pringle MB, Beasley P, Brightwell AP. The use of Merocel nasal packs in the treatment of epistaxis. J Laryngol Otol 1996;110:543-6.
• Laing MR, Clark LJ. Analgesia and removal of nasal packing. Clin Otolaryngol Allied Sci 1990;15:339-42.
• Johnson HA. The perfect nasal packing. Plast Reconstr Surg 1986;77:337-8.
• Fanous N. The absorbable nasal pack. J Otolaryngol 1980;9:462-7.
• Morgan NJ, Soo G, Frain I, Nunez DA. Do ventilated packs reduce post-operative eustachian tube dysfunc- tion? Clin Otolaryngol Allied Sci 1995;20:411-2.
• Tulunay EO, Tulunay FC, Gulmez SE, Ergun H, Demireller A. The analgesic efficacy of dipyrone dur- ing removal of nasal packings after septal surgery. J Headache Pain 2004;5:243-6.
• Lavy JA, Small GV, Jay N, Radcliffe GJ. A prospective randomized controlled study of 4% lignocaine solu- tion in Merocel nasal pack removal. Rhinology 1996; 34:219-21.
• Lachanas VA, Karatzias GT, Pinakas VG, Hatziioannou JK, Sandris VG. The use of tetracaine 0.25% solution in nasal packing removal. Am J Rhinol 2006;20:483-4.
• Muluk NB, Oguzturk O, Ekici A, Koc C. Emotional effects of nasal packing measured by the Hospital Anxiety and Depression Scale in patients following nasal surgery. J Otolaryngol 2005;34:172-7.