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A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation?

Year 2016, Volume: 26 Issue: 3, 152 - 158, 20.07.2016

Abstract

Objectives: 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. Patients and 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. Conclusion: 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.

References

  • Cruise AS, Amonoo-Kuofi K, Srouji I, Kanagalingam J, Georgalas C, Patel NN, et al. A randomized trial of Rapid Rhino Riemann and Telfa nasal packs following endoscopic sinus surgery. Clin Otolaryngol 2006;31:25- 32.
  • Weber RK. Nasal packing and stenting. GMS Curr Top Otorhinolaryngol Head Neck Surg 2009;8:2.
  • Samad I, Stevens HE, Maloney A. The efficacy of nasal septal surgery. J Otolaryngol 1992;21:88-91.
  • Bresnihan M, Mehigan B, Curran A. An evaluation of Merocel and Series 5000 nasal packs in patients following nasal surgery: a prospective randomised trial. Clin Otolaryngol 2007;32:352-5.
  • Certal V, Silva H, Santos T, Correia A, Carvalho C. Trans-septal suturing technique in septoplasty: a systematic review and meta-analysis. Rhinology 2012;50:236-45.
  • Titiz A, Zeyrek T, Ozcan M, Sabuncuoglu B, Yilmaz YF, Unal A. The effects of merocel and glove finger tampon applications on the nasal septum mucosa of rabbits. Rhinology 2008;46:112-5.
  • Hobson CE, Choby GW, Wang EW, Morton SC, Lee S. Systematic review and metaanalysis of middle meatal packing after endoscopic sinus surgery. Am J Rhinol Allergy 2015;29:135-40.
  • Lemmens W, Lemkens P. Septal suturing following nasal septoplasty, a valid alternative for nasal packing? Acta Otorhinolaryngol Belg 2001;55:215-21.
  • Weber R, Hochapfel F, Draf W. Packing and stents in endonasal surgery. Rhinology 2000;38:49-62.
  • 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.
  • Eşki E, Güvenç IA, Hızal E, Yılmaz I. Effects of nasal pack use on surgical success in septoplasty. Kulak Burun Bogaz Ihtis Derg 2014;24:206-10.
  • Bresnihan M, Mehigan B, Curran A. An evaluation of Merocel and Series 5000 nasal packs in patients following nasal surgery: a prospective randomised trial. Clin Otolaryngol 2007;32:352-5.
  • Garth RJ, Brightwell AP. A comparison of packing materials used in nasal surgery. J Laryngol Otol 1994;108:564-6.
  • Watson MG, Campbell JB, Shenoi PM. Nasal surgery: does the type of nasal pack influence the results? Rhinology 1989;27:105-11.
  • Illum P, Grymer L, Hilberg O. Nasal packing after septoplasty. Clin Otolaryngol Allied Sci 1992;17:158-62.
  • Shaw CL, Dymock RB, Cowin A, Wormald PJ. Effect of packing on nasal mucosa of sheep. J Laryngol Otol 2000;114:506-9.
  • von Schoenberg M, Robinson P, Ryan R. Nasal packing after routine nasal surgery--is it justified? J Laryngol Otol 1993;107:902-5.
  • Shinkwin CA, Beasley N, Simo R, Rushton L, Jones NS. Evaluation of Surgicel Nu-knit, Merocel and Vasolene gauze nasal packs: a randomized trial. Rhinology 1996;34:41-3.

Septoplasti sonrası burun içi tamponların karşılaştırmalı çalışması: Hastanın konforu, kanama ve kabuk veya şinesi oluşumu açısından önem arz eder mi?

Year 2016, Volume: 26 Issue: 3, 152 - 158, 20.07.2016

Abstract

Amaç: Bu çalışmada septoplasti sonrası burun içi tampon kullanılan ve kullanılmayan hastalarda ağrı, kanama, burun tıkanıklığı, kabuk ve sineşi oluşumu ve anesteziye bağlı morbidite karşılaştırıldı.Hastalar ve Yöntemler: Bu prospektif kohortta genel anestezi altında Cottle septoplastisi yapılan toplam 66 hasta, 32 kadın, 34 erkek; ort. yaş 24 yıl; dağılım 18-48 yıl rastgele üç gruba ayrıldı. Dikişli + telfa grup n=22 telfa burun içi tamponlar ve yalnız merosel grupta n=22 merocell burun içi tamponlar kullanıldı. Dikişsiz grupta ise n=22 tampon kullanılmadı. Üç grup anestezi sonrası burun tıkanıklığı, kanama, ağrı, kabuk ve sineşi oluşumunun yanı sıra, sekresyon miktarı, orofarengeal hava yolu gereksinimi, larengospazm varlığı ve burundan nefes alabilme açısından karşılaştırıldı.Bulgular: Dikişsiz grupta kanama miktarı daha fazla ve burun tıkanıklığı derecesi daha düşüktü. Ağrı ve sekresyon yalnız merosel grupta daha belirgindi. Birinci haftadan sonra, gruplar arasındaki bu farklılıklar belirsizleşti. Septal cerrahiden iki hafta sonra kabuk ve sineşi oluşumu açısından üç grup arasında bir fark gözlenmedi.Sonuç: Kanamaya bağlı morbiditesi olan hastalarda burun içi tamponlar daha kullanışlı olurken, tıkayıcı uyku apnesi olan hastalarda burun içi tampon kullanılmadan uygulanan septoplasti daha uygun olabilir. Septoplastide burun içi tamponların kullanımı, hastaların özellikleri göz önünde bulundurularak, her hastaya göre belirlenmelidir

References

  • Cruise AS, Amonoo-Kuofi K, Srouji I, Kanagalingam J, Georgalas C, Patel NN, et al. A randomized trial of Rapid Rhino Riemann and Telfa nasal packs following endoscopic sinus surgery. Clin Otolaryngol 2006;31:25- 32.
  • Weber RK. Nasal packing and stenting. GMS Curr Top Otorhinolaryngol Head Neck Surg 2009;8:2.
  • Samad I, Stevens HE, Maloney A. The efficacy of nasal septal surgery. J Otolaryngol 1992;21:88-91.
  • Bresnihan M, Mehigan B, Curran A. An evaluation of Merocel and Series 5000 nasal packs in patients following nasal surgery: a prospective randomised trial. Clin Otolaryngol 2007;32:352-5.
  • Certal V, Silva H, Santos T, Correia A, Carvalho C. Trans-septal suturing technique in septoplasty: a systematic review and meta-analysis. Rhinology 2012;50:236-45.
  • Titiz A, Zeyrek T, Ozcan M, Sabuncuoglu B, Yilmaz YF, Unal A. The effects of merocel and glove finger tampon applications on the nasal septum mucosa of rabbits. Rhinology 2008;46:112-5.
  • Hobson CE, Choby GW, Wang EW, Morton SC, Lee S. Systematic review and metaanalysis of middle meatal packing after endoscopic sinus surgery. Am J Rhinol Allergy 2015;29:135-40.
  • Lemmens W, Lemkens P. Septal suturing following nasal septoplasty, a valid alternative for nasal packing? Acta Otorhinolaryngol Belg 2001;55:215-21.
  • Weber R, Hochapfel F, Draf W. Packing and stents in endonasal surgery. Rhinology 2000;38:49-62.
  • 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.
  • Eşki E, Güvenç IA, Hızal E, Yılmaz I. Effects of nasal pack use on surgical success in septoplasty. Kulak Burun Bogaz Ihtis Derg 2014;24:206-10.
  • Bresnihan M, Mehigan B, Curran A. An evaluation of Merocel and Series 5000 nasal packs in patients following nasal surgery: a prospective randomised trial. Clin Otolaryngol 2007;32:352-5.
  • Garth RJ, Brightwell AP. A comparison of packing materials used in nasal surgery. J Laryngol Otol 1994;108:564-6.
  • Watson MG, Campbell JB, Shenoi PM. Nasal surgery: does the type of nasal pack influence the results? Rhinology 1989;27:105-11.
  • Illum P, Grymer L, Hilberg O. Nasal packing after septoplasty. Clin Otolaryngol Allied Sci 1992;17:158-62.
  • Shaw CL, Dymock RB, Cowin A, Wormald PJ. Effect of packing on nasal mucosa of sheep. J Laryngol Otol 2000;114:506-9.
  • von Schoenberg M, Robinson P, Ryan R. Nasal packing after routine nasal surgery--is it justified? J Laryngol Otol 1993;107:902-5.
  • Shinkwin CA, Beasley N, Simo R, Rushton L, Jones NS. Evaluation of Surgicel Nu-knit, Merocel and Vasolene gauze nasal packs: a randomized trial. Rhinology 1996;34:41-3.
There are 18 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Eltaf Ayça Özbal Koç This is me

Seda Türkoğlu Babakurban This is me

Sermin Sayan Kibar This is me

Fuat Büyüklü This is me

Publication Date July 20, 2016
Published in Issue Year 2016 Volume: 26 Issue: 3

Cite

APA Özbal Koç, E. A., Türkoğlu Babakurban, S., Sayan Kibar, S., Büyüklü, F. (2016). A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation?. The Turkish Journal of Ear Nose and Throat, 26(3), 152-158.
AMA Özbal Koç EA, Türkoğlu Babakurban S, Sayan Kibar S, Büyüklü F. A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation?. Tr-ENT. July 2016;26(3):152-158.
Chicago Özbal Koç, Eltaf Ayça, Seda Türkoğlu Babakurban, Sermin Sayan Kibar, and Fuat Büyüklü. “A Comparative Study on Nasal Packing After Septoplasty: Does It Matter in Terms of Patient Comfort, Bleeding, and Crust or Synechia Formation?”. The Turkish Journal of Ear Nose and Throat 26, no. 3 (July 2016): 152-58.
EndNote Özbal Koç EA, Türkoğlu Babakurban S, Sayan Kibar S, Büyüklü F (July 1, 2016) A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation?. The Turkish Journal of Ear Nose and Throat 26 3 152–158.
IEEE E. A. Özbal Koç, S. Türkoğlu Babakurban, S. Sayan Kibar, and F. Büyüklü, “A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation?”, Tr-ENT, vol. 26, no. 3, pp. 152–158, 2016.
ISNAD Özbal Koç, Eltaf Ayça et al. “A Comparative Study on Nasal Packing After Septoplasty: Does It Matter in Terms of Patient Comfort, Bleeding, and Crust or Synechia Formation?”. The Turkish Journal of Ear Nose and Throat 26/3 (July 2016), 152-158.
JAMA Özbal Koç EA, Türkoğlu Babakurban S, Sayan Kibar S, Büyüklü F. A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation?. Tr-ENT. 2016;26:152–158.
MLA Özbal Koç, Eltaf Ayça et al. “A Comparative Study on Nasal Packing After Septoplasty: Does It Matter in Terms of Patient Comfort, Bleeding, and Crust or Synechia Formation?”. The Turkish Journal of Ear Nose and Throat, vol. 26, no. 3, 2016, pp. 152-8.
Vancouver Özbal Koç EA, Türkoğlu Babakurban S, Sayan Kibar S, Büyüklü F. A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation?. Tr-ENT. 2016;26(3):152-8.