The efficacy of silastic sheet nasal splints in endoscopic nasal septal repair surgery: a prospective, randomized, single‐blinded controlled trial

Al-Asousi, Fahad; Fan, Judy; Pascual, Athenea; Hernaiz-Leonardo, Juan Carlos; Javer, Amin R.

doi:10.1002/alr.22791

Cited by 2 publications

(7 citation statements)

References 10 publications

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“…They proceed to conclude that splints do not significantly change surgical outcome and can be avoided if need-be. 14 However, contrary to the studies previously mentioned and to our results, von Schoenberg et al found an increased incidence of intranasal adhesions in patients without splints. They used Exmoorsilastic plastic standard-size splints in their study.…”

Section: Discussioncontrasting

confidence: 99%

“…These exceptional scenarios when splints can/should be considered include compromise to the septal flap, large bleeding tear in the septum, injury to the turbinates and patients at increased risk of adhesions. 14 Limitation of this study includes a relatively small sample size.…”

Section: Discussionmentioning

confidence: 99%

“…NOSE scores at 6 and 12 weeks post‐operatively were not statistically different between the two groups. They proceed to conclude that splints do not significantly change surgical outcome and can be avoided if need‐be 14 …”

Section: Discussionmentioning

confidence: 99%

“…It is important to point out that even though our results encourage surgeons to avoid splints, there are some instances where splints were used despite randomisation. These exceptional scenarios when splints can/should be considered include compromise to the septal flap, large bleeding tear in the septum, injury to the turbinates and patients at increased risk of adhesions 14 …”

Section: Discussionmentioning

confidence: 99%

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The use of different intranasal splints Doyle splints versus Reuter bivalve splints versus no splints in primary septal surgeries: A randomised clinical trial looking at morbidity

Daou

Zaytoun

Hadi

et al. 2023

Clinical Otolaryngology

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ObjectiveThe objective of this study is to compare the morbidity of different types of intranasal splints (Doyle splints and Reuter bivalve splints) with no intranasal splints in primary septal surgeries and concomitant submucosal reduction of the inferior turbinate.DesignRandomised clinical trialSettingSingle‐Center trial at a tertiary care facilityParticipantsIn this randomised clinical trial, 123 consecutive patients underwent primary septoplasty with bilateral submucosal reduction of the inferior turbinate, with no other concurrent procedure. Patients were randomised into three groups: Doyle splints, Reuter bivalve splints and patients with no splints placed.Main Outcome MeasuresFollowing surgery, the patients were seen at three consecutive visits. During each visit, the Visual Analogue Scale score for headache, nasal obstruction, overall pain and bleeding and an endoscopic score for secretions, oedema and synechiae was filled.ResultsPatients were randomised into three groups, 42 received Doyle splints, 41 Reuter bivalve splints and 40 had no splints inserted. When comparing the three groups, the first two post‐op visits were scheduled significantly earlier in patients with splints (p < .05). The scores from both groups with splints were statistically higher for headache, nasal obstruction and pain, for the first visit only (p < .05). There was no statistical difference between groups when looking at each subset of the endoscopic score, at each visit (p > .05).ConclusionIncreased post‐operative pain, headaches and nasal obstruction scores were encountered in patients who had splints after surgery. However, endoscopic scores were statistically similar across the three groups with no difference in post‐operative endoscopic scores at each visit. and no difference was seen in symptom scores and endoscopic scores between patients with different splints.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The use of different intranasal splints Doyle splints versus Reuter bivalve splints versus no splints in primary septal surgeries: A randomised clinical trial looking at morbidity

Daou

Zaytoun

Hadi

et al. 2023

Clinical Otolaryngology

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“…Our study's relevance and significance in current medical literature rely on acknowledging the widespread use of ISS in septoplasty surgeries, which has generated interest and debate among professionals due to its impact on postoperative outcomes. 3,33 Deciding whether to adopt ISS routinely or selectively has led to varying practices across medical centres. Comparing recent techniques involving transseptal sutures to nasal packing, including ISS, studies have demonstrated the superiority of transseptal sutures in reducing postoperative pain and complications like epiphora, sleep disturbance, and dyspnea.…”

Section: Final Considerationsmentioning

confidence: 99%

Prophylactic antibiotics in septoplasty with intranasal septal splints: A comparative analysis

Zavdy,

Nakache,

Alkan

et al. 2023

Clinical Otolaryngology

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ObjectivesPostoperative antibiotic therapy is a common practice following septoplasty with intra‐septal splints placement (ISS), even though there is a lack of evidence to support it. We sought to investigate the role of antibiotic therapy in septal surgeries with the placement of ISS.DesignA retrospective comparative study was conducted using the electronic charts of adult patients who underwent septoplasty with the placement of ISS with or without turbinate reduction. Nasal cultures were taken routinely during surgery as part of the department's protocol for monitoring infectious diseases. The ISS were also routinely examined for the presence of bacteria after their removal on the eighth day following surgery.SettingA large otolaryngology department in a tertiary medical center.ParticipantsAdult patients who underwent septoplasty in our institution.Main outcome measuresWe analyzed all post‐operative infections to search for risk factors in the cohort.ResultsPost‐operative infection rates following septoplasty with ISS were low at 6%, which is consistent with previously published rates. Infection rates were significantly higher in patients who were not treated with antibiotics (OR = 8.2, 95%CI: 1.63–41.1; p = .01, φ = 0.04). Diabetes was associated with an increased risk of postoperative infection regardless of prophylactic antibiotic therapy (OR = 5.2, 95%CI: 1.15–23.5; p = .032, φ = .04). The detection of Klebsiella pneumonia before surgery was associated with an increased rate of postoperative infection (OR = 16.6, 95%CI: 3.02–91.54; p = .001, φ = 0.12).ConclusionsPatients undergoing septoplasty with the placement of ISS are at increased risk of gram‐negative bacterial colonisation, and development of postoperative nasal infection. A single preoperative dose of IV antibiotic therapy should be considered a potential prophylactic option for septoplasty with ISS.

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The efficacy of silastic sheet nasal splints in endoscopic nasal septal repair surgery: a prospective, randomized, single‐blinded controlled trial

Abstract: Javer AR. The efficacy of silastic sheet nasal splints in endoscopic nasal septal repair surgery: a prospective, randomized, single-blinded controlled trial. Int

Cited by 2 publications

References 10 publications

The use of different intranasal splints Doyle splints versus Reuter bivalve splints versus no splints in primary septal surgeries: A randomised clinical trial looking at morbidity

The use of different intranasal splints Doyle splints versus Reuter bivalve splints versus no splints in primary septal surgeries: A randomised clinical trial looking at morbidity

Prophylactic antibiotics in septoplasty with intranasal septal splints: A comparative analysis

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