A Comparative Study of the Effects of Anterior Nasal Packing versus Trans-Septal Suturing in Post-Septoplasty Patients

Abstract

Introduction
 Following septoplasty, the usual norm is to pack the nose using polyvinyl alcohol or white petroleum jelly impregnated gauze. But due to side effects like pain, respiratory problems, headache or pain during pack removal, trans-septal suturing is recommended as it provides stability and prevents septal hematoma formation without causing the above mentioned complaints. This study aims to conduct an in-depth comparison of the outcomes of the two aforementioned methods in an Indian population.Materials and Methods 
 A prospective randomized comparative study was done for 30 patients between 18-50 years undergoing septoplasty, while excluding those requiring additional surgical interventions. Trans-septal suturing was done for 15 patients and polyvinyl alcohol nasal packing for the rest. Visual Analogue Scale was used to record discomfort levels 1 day post-operatively. A vast multitude of symptoms were assessed during regular visits for 3 months after surgery. 
 Results
 Post-operatively, nasal pain, headache, dyspnoea, sleep disturbance, post-nasal drip, crusting, and epiphora were found to be reduced in patients who underwent trans-septal suturing when compared with packing, deeming it to be a superior choice of method. However, nasal bleeding was comparable in both groups.
 Conclusion
 Trans-septal suturing reduces pack related problems and post-operative complications, without significantly increasing the duration of surgery. Hence, we recommend the practice of placing sutures to positively improve patients’ quality of life post-surgery.