Septoplasti Sonrası Transseptal Sütür ile Nazal Tamponların Karşılaştırılması

Öz

Amaç: Nazal tamponlar septoplasti sonrası yaygın olarak kullanılır. Bununla birlikte, literatürde nazal tampon kullanımı ile ilişkili çok sayıda komplikasyon vardır. Bu çalışmada, septoplasti uygulanan hastalarda transseptal sütür tekniği (TSS) ile üç farklı tip nazal tampon postoperatif komplikasyonlar ve operasyon sonrası hasta memnuniyeti açısından karşılaştırıldı.

Gereç ve Yöntem: Çalışma grubuna septoplasti uygulanan 80 hasta dahil edildi: Hastalar 4 gruba ayrıldı. Merocel grubu (grup 1), internal nasal splint (INS) grubu (grup 2), sentetik poliüretan köpük (SPK) grubu (grup 3) ve TSS grubu (grup 4). Grupların VAS skorları ağrı (tamponlu kaldığı süre içerisinde, tamponun çıkarılması sırasında), basınç hissi, disfaji ve postnazal akıntı açısından karşılaştırıldı. Her grupta kanama, sineşi, septal hematom ve septal perforasyon gibi komplikasyonlar karşılaştırıldı.

Bulgular: Tamponlu kaldığı süre içerisinde ve tamponların çıkarılması sırasındaki postoperatif ortalama ağrı, basınç hissi ve disfaji VAS skorları Merocel grubunda silikon ve Nasopore gruplarına göre anlamlı olarak yüksek bulundu. Diğer üç grup arasında VAS skorları açısından anlamlı fark yoktu. Kanama oranı Merocel grubunda en yüksek, TSS grubunda en düşüktü. Sineşi oranı Merocel grubunda en yüksek, ardından TSS ve SPK grupları ile en düşük INS grubundaydı. Gruplar arasında septal hematom ve septal perforasyon açısından fark yoktu.

Sonuç: Sonuçlarımız septoplasti hastalarında TSS tekniğinin yüksek hasta memnuniyeti ve düşük komplikasyon oranları açısından güvenle kullanılabileceğini göstermiştir. Merocel, yüksek komplikasyon oranları ve düşük hasta yaşam kalitesi nedeniyle septoplasti için uygun bir materyal gibi görünmemektedir.

Anahtar Kelimeler

• Septoplasti,nazal tamponlar,transseptal sütür tekniği

Comparison of the Transseptal Suturing with Nasal Packs After Septoplasty

Öz

Objective: Nasal packs are commonly used after septoplasty. However, there are numerous complications associated with nasal packing in the literature. This study aimed to compare the efficacy of transseptal suture technique (TSS) versus three different types of nasal packs regarding to postoperative complications and patient satisfaction after septoplasty. 

Material and Method: The study group included 80 patients who underwent septoplasty. The patients were randomly divided into four groups: Merocel group (group 1), internal nasal splint (INS) group (group 2), synthetic polyurethane foam (SPF) group (group 3) and TSS group (group 4). The VAS scores of groups were compared for pain (during pack, on removal of the pack), sense of pressure, dysphagia and postnasal drip. The complications including bleeding, synechiae, septal hematoma and septal perforation were also compared for each group. 

Results: The mean VAS scores of postoperative pain during packed and on removal of packs, sense of pressure and dysphagia found significantly higher in Merocel group than in silicone and Nasopore groups. There was no significant difference between other three groups regarding to VAS scores. Bleeding ratio was highest in Merocel group, and lowest in TSS group. Synechiae ratio was highest in Merocel group followed by TSS and SPF groups and lowest in INS group. There was no difference between groups regarding to septal hematoma and septal perforation.

Conclusion: Our results showed that TSS technique might be safely used in septoplasty patients regarding to high patient’s satisfaction and low complication ratios. Merocel does not seem to be an appropiate material for septoplasty due to its high complication and low patient’s quality of life ratios. 

Anahtar Kelimeler

• Septoplasty,nasal packs,transseptal suture technique

Kaynakça

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