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

Yıl 2016, Cilt: 26 Sayı: 3, 152 - 158, 20.07.2016

Eltaf Ayça Özbal Koç Seda Türkoğlu Babakurban Sermin Sayan Kibar Fuat Büyüklü

Öz

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.

Anahtar Kelimeler

Bleeding, merocell, nasal obstruction, nasal pack, pain, septoplasty, telfa

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

Öz

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

Anahtar Kelimeler

Kanama, merocell, burun tıkanıklığı, burun içi tampon, ağrı, septoplasti, telfa

Kaynakça

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