Nasal packing after routine nasal surgery—is it justified?

Schoenberg, Marcelle Von; Robinson, Philip; Ryan, Rowena

doi:10.1017/s0022215100124740

Cited by 120 publications

(90 citation statements)

References 5 publications

(6 reference statements)

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“…In a study done by Schoenberg et al [6], the MPS in packed group was 4.2 and in unpacked group 2.8. In another study done by Nunez et al [7], they also found a significantly greater extent of post-operative pain in the packed group.…”

Section: Discussionmentioning

confidence: 90%

Nasal Septal Clips: An Alternative to Nasal Packing After Septal Surgery?

Anand

Handa

Shivaswamy

2011

Indian J Otolaryngol Head Neck Surg

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Surgeons have debated since decades on the efficacy or inefficacy of nasal packing yet it is considered routine after septal surgery. Various types of septal splints have been tried as an alternative to nasal packs but most of them need to be sutured around the septum which requires a meticulous approach and expertise. Our aim is to assess and compare the immediate post-operative morbidity and the eventual outcome of septal surgery while using glove finger packs with that of septal clips with splints. This comparative study was done at MCV Memorial ENT Trust Hospital on 80 patients who were diagnosed to have DNS and underwent septal surgery. Patients were divided into two groups. Group A (n = 40) constituted of patients who had glove finger packs and Group B (n = 40) constituted of patients who had septal clips. In the immediate postoperative period patients were assessed for pain, headache, dysphagia, epiphora, dryness of mouth and post-operative bleed. On the first post-operative night, patients were assessed for oxygen saturation. Patients underwent tympanometry just before pack/splint removal and on reviews if the same was abnormal. Post-operative complications like septal perforation and synechiae were noted for both groups and compared. We found that the incidence of pain and various other signs and symptoms was significantly higher in Group A. The difference in the complication rates among the two groups was not statistically significant. We observed that nasal packing is a cause for significant morbidity and discomfort in the immediate post-operative period and does not give any added advantage over septal clips used in our study as far as the final outcome is concerned. Nasal septal clips with splints are a useful alternative to existing techniques of flap approximation after septal surgery. The method is not expensive and needs no special expertise.

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Section: Discussionmentioning

confidence: 90%

Nasal Septal Clips: An Alternative to Nasal Packing After Septal Surgery?

Anand

Handa

Shivaswamy

2011

Indian J Otolaryngol Head Neck Surg

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“…Many authors believe that nasal packing postoperatively is not needed if proper technique is followed and should thus be avoided to prevent significant morbidity associated with nasal packing 5,6 . Some authors argue that packing should be reserved for cases where there is concern about persistent haemorrhage 7 . Though these arguments carry enough weightage, packing of nasal cavities postoperatively is usually done in almost all parts of the world.…”

Section: Introductionmentioning

confidence: 99%

Comparing hemostatic and adhesion prevention effects of different types of nasal packings used post-septoplasty viz medicated gauze packing, glove finger packing and merocel packing

Mattoo

Muzaffar

Mir

et al. 2012

Bangladesh J of Otorhinolaryngology

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“…ANS packing is also commonly performed after a variety of septal or other nasal surgeries to control post-operative bleeding. Though some study raised the question of effectiveness of post septal surgery ANS packing over no packing and even advocated for the later [3][4][5]. There are a variety of materials used for nasal packing, starting from conventional gauze pack (lubricated with paraffin or antiseptic cream) and bismuth iodoform paraffin paste pack.…”

Section: Introductionmentioning

confidence: 99%

Modified Technique of Anterior Nasal Packing: A Comparative Study Report

Dutta

Mukherjee

Saha

et al. 2011

Indian J Otolaryngol Head Neck Surg

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Anterior nasal packing, which is a common procedure in otorhinolaryngology practice, has different complications. Pain during introduction and removal of pack, bleeding after removal due to mucosal damage and synechia formation are common among them. A continuous effort is going on worldwide to combat those by modifying the nature of pack material or inventing new materials for nasal packing. In the present study an effort was made to compare a new modification of conventional gauze pack by using aluminum foil prepared from the cover of suture materials as septal splint (to reduce the mucosal damage) with conventional gauze pack and another costly material, nasal tampon (merocel). Comparisons were done in terms of cost, efficacy and complications. Prospective hospital based interventional study. Patients were distributed into three groups according to the material used for anterior nasal packing. Comparisons were made in terms of cost of the material used, pain during introduction of pack, rise of systolic blood pressure, incidences of bleeding while pack in situ, incidences of bleeding after removal of pack that required repacking and incidences of synechia formation after pack removal. The episodes of bleeding while pack in situ, within first 48 h and forced for repacking was observed to be significantly more prevalent among nasal tampon groups (12.5%) of patients but only 2.1 and 2.4% with use of conventional gauze pack and our modification respectively. Regarding bleeding after removal of pack, 10.6% patients experienced bleeding with conventional gauze pack, whereas with our modification it was only 2.4%. Synechia formation was found to be highest among the cases with conventional gauze pack (14.9%), but with our modification it is only 2.4%. In this study it is found that use of aluminum foil prepared from the cover of suture materials can be very useful and cost effective method to reduce some of the complications of anterior nasal packing.

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Nasal packing after routine nasal surgery—is it justified?

Cited by 120 publications

References 5 publications

Nasal Septal Clips: An Alternative to Nasal Packing After Septal Surgery?

Nasal Septal Clips: An Alternative to Nasal Packing After Septal Surgery?

Comparing hemostatic and adhesion prevention effects of different types of nasal packings used post-septoplasty viz medicated gauze packing, glove finger packing and merocel packing

Modified Technique of Anterior Nasal Packing: A Comparative Study Report

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