The comparison of trans-septal suture, Merocel nasal packing and septal splint following septoplasty combined with inferior turbinate surgery

Abstract

Bulgular: Septoplasti ile eşzamanlı yapılan RFTA sonrası splint, Merocel tampon ve trans-septal sütür alt gruplarında, ameliyat sonrası ağrı hariç diğer araştırma parametrelerinde istatistiksel farklılık yoktu. Parsiyel inferior turbinektomi yapılan grupta Merocel tampon uygulanan beş, trans-septal sütür uygulanan altı, splint uygulanan bir hastada nazal sineşi gelişmesine rağmen sineşi ve diğer araştırma parametreleri arasındaki fark istatistiksel olarak anlamlı bulunmadı. Splint, trans-septal sütür ve Merocel tampon uygulanan gruplarda, ameliyat sonrası ağrı düzeyi en yüksek tampon gruplarında ve en düşük trans-septal sütür gruplarında tespit edildi.Sonuç: Septoplasti ile kombine RFTA cerrahilerinde trans-septal sütür uygulamasının, septoplasti ile kombine PİT cerrahilerinde ise splint kullanımının nazal tampon uygulamasına tercih edilmesi, tamponun neden olduğu ağrı, rahatsızlık ve komplikasyonların engellenmesine ve hastalara daha konforlu ameliyat sonrası dönem sunulmasına katkı sağlayacaktır.Anahtar sözcükler: Merocel nazal tampon; nazal splint; parsiyel inferior türbinektomi; radyofrekans termal ablasyon; septoplasti; trans-septal sütür. ABSTR ACTObjectives: This study aims to investigate the efficacy of nasal splint, Merocel nasal packing and trans-septal suturing applications in septoplasty combined with inferior turbinate surgeries in the prevention of postoperative pain and complications. Patients and Methods:Between January 2014 and October 2015 a total of 180 patients (129 male, 51 female; mean age 31.32±10.27 years; range 18 to 55 years) for which septoplasty concurrent with inferior turbinate surgery was planned were included in this study. Following septoplasty, patients were divided into two equal groups to apply Radiofrequency Thermal Ablation (RFTA) and Partial Inferior Turbinectomy (PIT). Both patient groups were separated into three subgroups in themselves to apply nasal splint, Merocel packing and trans-septal suturing, so that each group would have 30 patients. The duration of surgery, minor and major hemorrhage, postoperative pain evaluated at the 6 th hour, on the 1 st , 2 nd and 3 rd day, and postoperative complications in the 6 th week (septal perforation, hematoma, infection, crusting, nasal synechiae) were compared.Results: There was no statistical difference in research parameters except for the postoperative pain in three subgroups applied splint, Merocel packing, and trans-septal suture after RFTA concurrent with septoplasty surgery. Although nasal synechia developed in five patients who were applied Merocel packing, in six patients who were applied trans-septal suture and in one patient who was applied splint in the group in which PIT was performed, the difference between synechiae and other research parameters was statistically insignificant. The highest level of postoperative pain was determined in the Merocel packing groups, and the lowest level was determined in the groups that were applied trans-septal suture at the groups in which splint, Merocel packing, and trans-septal s...