Efficacy of nasal septal splints for preventing complications after septoplasty: A meta-analysis

Kim, Su Jin; Chang, Dong Sik; Choi, Myoung Su; Lee, Ho Yun; Pyo, Jung‐Soo

doi:10.1016/j.amjoto.2020.102389

Cited by 15 publications

(16 citation statements)

References 39 publications

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“…Intranasal splints also help promote the healing process by providing the above along with moisturizing and humidifying the nasal mucosa, protecting the healing septal mucosa from external trauma, and helping to stabilize the remaining cartilages. Interestingly, a recent meta‐analysis on the efficacy of nasal septal splints for preventing complications after septoplasty reported no difference in the estimated rates of infection, bleeding, hematoma, or perforation when comparing the splint to the no splint group 6 . Similarly, our analysis shows no significant difference when comparing the closure rates of NSPs that used intranasal splints, packing, or both versus those that used neither.…”

Section: Discussioncontrasting

confidence: 43%

“…Interestingly, a recent meta-analysis on the efficacy of nasal septal splints for preventing complications after septoplasty reported no difference in the estimated rates of infection, bleeding, hematoma, or perforation when comparing the splint to the no splint group. 6 Similarly, our analysis shows no significant difference when comparing the closure rates of NSPs that used intranasal splints, packing, or both versus those that used neither. Most of the studies that did not use splints or packing reported stabilizing the mucoperichondrial flaps to the septal cartilage or graft by using through-and-through sutures (or a similar technique, e.g., staples).…”

Section: Discussionmentioning

confidence: 53%

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Surgical repair of nasal septal perforations: A systematic review and meta‐analysis

Fermin

Bui

McCoul

et al. 2022

Int Forum Allergy Rhinol

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Background: A wide variety of techniques for the surgical repair of nasal septal perforations (NSPs) have been described. Surgical management of NSPs can be broadly divided into open versus endonasal approaches, with additional variables involving unilateral or bilateral flaps, use of grafts, and placement of splints. The objective of this study was to compare surgical approaches and their outcomes. Methods: PubMed, EMBASE, and CINAHL Plus databases were examined for patients undergoing NSP repair. English-language studies reporting surgical management of patients with the primary diagnosis of NSP were included. Outcome measures of interest included perforation size, surgical approach characteristics, and success rate defined as complete closure assessed by surgeon postoperatively. The quality of articles was assessed with the methodological index for nonrandomized studies (MINORS) criteria. A random-effects model was used to calculate pooled proportions for the different outcomes. Results:The electronic database search yielded 1076 abstracts for review. A total of 64 articles met the inclusion criteria, with 1591 patients: 1127 (71%) underwent an endonasal approach and 464 (29%) an open approach. The median (range) MINORS score was 10 (5-12) out of 16 points. Overall, 91% of patients had total closure (95% confidence interval [CI], 0.89-0.93, p < 0.01), with moderate heterogeneity between studies (I 2 = 42.03%). There was no difference in closure success between open and endonasal approaches. Use of bilateral versus unilateral flaps, interposition grafts, and intranasal splints and packing were not associated with differences in outcomes. Conclusion:Nasal septal perforation surgical repair success rates are comparable regardless of technique.

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Section: Discussioncontrasting

confidence: 43%

Section: Discussionmentioning

confidence: 53%

Surgical repair of nasal septal perforations: A systematic review and meta‐analysis

Fermin

Bui

McCoul

et al. 2022

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

show abstract

“…The other symptoms like headache, rhinorheas, sneezing, snoring and hyposmia were relieved in nearly the same percentage and showed no significant difference. Other studies also agree that splints added no demonstrable benefit to the patient regarding the position of the septum and patency of the airways [6,8,11,12,13]. Recently the advisability of using these splints and / or packing has been challenged.…”

Section: Discussionmentioning

confidence: 99%

Evaluate Functional Outcomes of Postoperative Septoplasty with and Without Splints and Packing

Rajput¹,

Mahar²,

Ansari

et al. 2022

JPRI

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Aim: To evaluate functional outcomes of septoplasty with and without splints and packing. Methodology: This cross sectional study was done at ENT department PUMHSW Nawabshah Pakistan. In this study 100 patients were selected who underwent septoplasty procedure both under local and general anaesthesia. This sample size was divide into two groups, group 1 (n=50) had splints and packing while the other group 2 had not. This study was approved by ethical review committee PUMHSW Nawabshah. Written inform consent was taken from all participants. Written proforma was used to analyze functional results of septoplasty with and without splint and packing. Results: Out of 50 patients who were having nasal obstructions 3 (69%) were relieved in group 1 33(66%) were relived in cases of group 2. Headache were relieved in 20 out 30 patients (66%) and 20 out 27 (74%) in cases group1 and 2 respectively. Rhinorhea was relieved in 9 out of 18 patients (50%) in group 1 while 5 out 11 (48%) in group 2. Conclusion: There was no significant difference regarding post operative functional outcomes in both groups.

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“…Preventative measures that have been described include temporary postoperative intranasal packing, splints, anti-adhesion agents, frequent postoperative saline irrigation, and close postoperative surveillance. 19,26,27 When postoperative NAs have formed, most authors recommend aggressive adhesiolysis, either as an in-office procedure or in the operating room. [28][29][30] Despite the observed significant impact of postoperative NAs, there remains a lack of objective evidence in the literature that examines the cause or the physiological mechanism for the disproportionate symptom profile.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Impact of Adhesions on Nasal Airflow: A Quantitative Analysis Using Computational Fluid Dynamics

Senanayake

Warfield-McAlpine

Salati

et al. 2022

Am J Rhinol�Allergy

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Background Nasal adhesions (NAs) are a known complication of nasal airway surgery. Even minor NAs can lead to significant postoperative nasal airway obstruction (NAO). Division of such NAs often provides much greater relief than anticipated. Objective We examine the impact of NAs at various anatomical sites on nasal airflow and mucosal cooling using computational fluid dynamics (CFD) and multiple test subjects. Methods CT scans of healthy adult subjects were used to construct three-dimensional nasal airway computational models. A single virtual 2.5 mm diameter NA was placed at one of five sites commonly seen following NAO surgery within each nasal cavity bilaterally, resulting in 10 NA models and 1 NA-free control for each subject. CFD analysis was performed on each NA model and compared with the subject's NA-free control model. Results 4 subjects were recruited to create 44 computational models. The NAs caused the airflow streamlines to separate, leading to a statistically significant increase in mucosal temperature immediately downstream to the NAs (wake region). Changes in the mucosal temperature in the wake region of the NAs were most prominent in anteriorly located NAs with a mean increase of 1.62 °C for the anterior inferior turbinate NAs ( P < .001) and 0.63 °C for the internal valve NAs ( P < .001). Conclusion NAs result in marked disruption to airflow patterns and reduced mucosal cooling on critical surfaces, particularly in the wake region. Reduced wake region mucosal cooling may be a contributing factor to the exaggerated perception of nasal obstruction experienced by patients with NAs.

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Efficacy of nasal septal splints for preventing complications after septoplasty: A meta-analysis

Cited by 15 publications

References 39 publications

Surgical repair of nasal septal perforations: A systematic review and meta‐analysis

Surgical repair of nasal septal perforations: A systematic review and meta‐analysis

Evaluate Functional Outcomes of Postoperative Septoplasty with and Without Splints and Packing

The Impact of Adhesions on Nasal Airflow: A Quantitative Analysis Using Computational Fluid Dynamics

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