Nasal Packing after Functional Endoscopic Sinus Surgery

Abstract

This chapter was to have a systematic review and meta-analysis on the available literature in order to compare the eicacy and postoperative outcomes of nasal packing (absorbable vs. nonabsorbable) after treatment of chronic rhinosinusitis with functional endoscopic sinus surgery (FESS). The systematic review included ive studies with 241 nasal cavities in each treatment group. The prevalence of synechia in the absorbable groups ranged from 4.6 to 8.0% while nonabsorbable groups ranged from 8.0 to 35.7%. The absorbable group had a lower postoperative bleeding; however, there were no clear indings on postoperative pain. Postoperative edema was in general similar among groups, and no consistent indings were found on bleeding and pain while removing packing. The meta-analysis included two studies using the same type of packing material. The combined OR (0.33, 95% CI = 0.04-2.78) for postoperative synechia did not signiicantly favor (P = 0.016308) absorbable packing over nonabsorbable packing. The available literature showed that there is some evidence that absorbable nasal packing may provide superior outcomes to nonabsorbable packing after FESS. However, lack of homogeneity between these studies makes it impossible to have a deinitive conclusion.

Postoperative Pain Following Functional Endoscopic Sinus Surgery

“…Today, there are a variety of options, ranging from absorbable to nonabsorbable nasal packing, and some surgeons prefer no packing at all. Regarding postoperative pain, numerous studies have shown that nasal packing increases the intensity of pain, especially nonabsorbable nasal packing 19 .…”