Is nasal packing really required after septoplasty?

Bajaj, Yogesh; Kanatas, Anastasios; Carr, Simon; Sethi, Neeraj; Kelly, George E

doi:10.1111/j.1742-1241.2008.01799.x

Cited by 29 publications

(32 citation statements)

References 21 publications

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“…79.3% of patients with nasal packing had post operative pain, headache and discomfort compared to 25.7% of patients without nasal packing. Bajaj et al [3] showed decreased rates of postoperative complications in patients who have undergone septoplasty without nasal packing. The study done by Awan and Iqbal [4] showed similar results.…”

Section: Resultsmentioning

confidence: 98%

A Comparative Study of Septoplasty With or Without Nasal Packing

Walikar

Rashinkar

Watwe

et al. 2011

Indian J Otolaryngol Head Neck Surg

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This study was conducted to compare the outcome of septoplasty with or without Nasal packing. The study subjects were randomly allocated into two groups. There was significant reduction in frequency of post operative pain, headache, discomfort and duration of hospital stay in patients who have undergone septoplasty without nasal packing. However there was no difference in post operative bleeding and septal perforation between two groups. Therefore after Septoplasty without nasal packing is preferred alternative to with nasal packing.

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Section: Resultsmentioning

confidence: 98%

A Comparative Study of Septoplasty With or Without Nasal Packing

Walikar

Rashinkar

Watwe

et al. 2011

Indian J Otolaryngol Head Neck Surg

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“…However, we applied two to four horizontal, vertical or oblique separate sutures, changing according to the elevated parts of the septum. Transseptal suturing technique was previously reviewed by Lemmens et al [7] in 226 and by Bajaj et al [8] in 78 consecutive cases retrospectively and postoperative complication rates were shown to be comparable to nasal packing. Ardehali et al [3] used separate sutures in 114 cases in a prospective randomized study and found no signiWcant diVerence between the transseptal suture and the nasal packing groups in terms of postoperative bleeding, hematoma, perforation and synechiae, but reported signiWcantly higher pain levels in the packing group.…”

Section: Discussionmentioning

confidence: 94%

Nasal packing and transseptal suturing techniques: surgical and anaesthetic perspectives

Günaydın

Aygenç

Karakullukcu

et al. 2011

Eur Arch Otorhinolaryngol

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The objective of this study is to compare the nasal packing and the transseptal suturing techniques regarding the extubation difficulty evaluation scores, follow-up times in post-anaesthesia care unit (PACU), pain scores, and postoperative complications. Two hundred patients who underwent septoplasty from January 2009 to October 2009 were randomly assigned either to have nasal packs (n: 100) or transeptal sutures (n: 100). In the transseptal suture group, extubation was easier and PACU follow-up times were shorter, when compared to the nasal packing group (p < 0.001). Patients with nasal packing had significantly higher pain scores (p < 0.001). Minor bleeding was significantly higher in the transseptal group with seven cases, compared to the nasal packing group without any bleeding cases (p = 0.014). There were two patients who had postoperative major bleeding, and two patients who had septal hematoma in the transseptal suture group. One patient with nasal packing had postoperative infection. Septal perforation was not seen in any of the cases. While patients in both groups experienced postoperative crusting, patients in the transseptal suture group also complained about foreign body sensation. Extubation was more comfortable; post-anaesthesia monitorization duration was shorter, and postoperative pain was less, but minor bleeding was seen more with transseptal sutures. There was no significant difference in terms of major bleeding, hematoma, infection or perforation. Foreign body sensation was the main cause of postoperative discomfort in the transseptal suture group. Transseptal suturing might be a significantly comfortable, cost-effective and reliable alternative to nasal packing.

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“…In contrast, in a single-centre retrospective non-comparative study of 78 patients undergoing day-case septoplasty under general anesthesia without nasal packing but with mucoperichondral flap suture, 19 patients (24.3%) had to be kept in hospital, including 6 (7.7%) for epistaxis, 3 of whom required packing [17]. A more recent retrospective comparative study of 697 septoplasty patients found no significant difference in rates of postoperative epistaxis and septal hematoma between the 363 patients with trans-septal suture and the 334 with 48 hours' bilateral packing; the only difference concerned postoperative pain (2.3 vs. 4.8, respectively; P < 0.05) [18].…”

Section: Guidelinementioning

confidence: 88%

“…Readmission and bleeding rates did not differ according to packing or postoperative trans-septal suture [3,17,18].…”

Section: Guideline 16mentioning

confidence: 99%