Objective: To compare silicone nasal septal splints with integral airway and a polyvinyl alcohol (PVA) sponge after septoplasty in terms of patient comfort (both with the pack in place and during removal) and postoperative complications. Methods: This study involved 169 patients who underwent septoplasty without additional nasal procedures due to nasal septal deviation. They were allocated into two groups. Group A comprised 90 patients who underwent septoplasty and who were packed with silicone nasal septal splints. Group B comprised 76 patients who underwent septoplasty and who were packed with a PVA sponge. They were removed on the second postoperative day. Patients were asked to record pain levels using a visual analog scale (VAS). Results: The patients in the groups had similar mean ages: 29.77 years (range, 19-74 years) and 23.77 years (range, 21-37 years) in Group A and Group B, respectively (p>0.05). VAS scores were significantly lower in Group A than in Group B at the 1 st , 2 nd , 4 th , 8 th , 12 th , 24 th , 48 th , and 72 nd postoperative hours (p<0.0001). There were significantly higher pain levels associated with PVA sponge pack removal than with silicone nasal septum splint removal (average pain scores: 3.57 vs. 1.99, respectively; p<0.05). Conclusion: Intranasal septal splints with integral airway result in less postoperative pain during removal without increasing postoperative complications; thus, they can be used as an effective alternative to PVA sponge packing after septoplasty.
The aim of this study is to evaluate the effects of intrapolyp, systemic and local corticosteroid treatment modalities on MMP-9 and TIMP-1 level in polyp tissues. This study included 71 patients and five groups. Group A treated with oral methylprednisolone, Group B, treated with topical steroid spray, Group C treated with intralesional triamcinolone acetonide, Group D patients with nasal polyposis who has not given any medication, Group E had surgery for concha bullosa without nasal polyp disease. Samples from group A were collected endoscopically 1 day after treatment was stopped. Group B samples were collected at the end of the first month. Video guided sample collection from Group C was also performed on the 7th day after treatment. MMP-9 and TIMP-1 levels were measured by Enzyme-linked immunosorbent assay method. When we compared the MMP-9 levels of all groups, there were no significant differences. There was significant difference of TIMP-1 level between Groups C and E (p C-E = 0.0019), however there was no difference among the level of the other groups. When MMP-9/TIMP1 rates of all groups were compared, there were significant difference between Group A and D (p A-D = 0.005) and between Group A and E, also between Group C and E. Our study is the first study to evaluate the effects of different corticosteroid treatment modalities on MMP-9 and TIMP-1 in nasal polyps and concluded that corticosteroid did not do a significant impact on this pathway.Keywords Nasal polyposis Á Matrix metalloproteinase inhibitor Á Matrix metalloproteinase-9 Á Corticosteroid Á Therapy
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