Packing in Endoscopic Sinus Surgery: Is it Really Required?

Abstract

Most ESS procedures can be managed without packing or any other hemostatic measures. Local anesthesia, use of local vasoconstrictors, and careful operative technique minimize the need for nose packing, thus reducing patient's discomfort, postoperative complications, and cost of surgery.

Univariate and multivariate analyses for postoperative bleeding after nasal endoscopic surgery

“…However, few studies have examined this problem. Our data demonstrated that the rate of postoperative bleeding after NES in the present study was 8.4%, which was similar to previous findings in other studies [5,6]. Statistical analysis showed that a history of hypertension, use of long-term NSAIDs, previous NES, modified submucosal septoplasty, and preoperative corticosteroids were correlated significantly with the condition.…”

Middle turbinate medialization for improved access during endoscopic sinus surgery

“…In addition, our technique allows the avoidance of postoperative nasal packing, which can incite pain, rhinorrhea, nasal obstruction, and bleeding. 12 It is important to note that a learning curve does exist in developing the surgical skills necessary to place the medialization suture. However, it has been our experience that these skills are easily achievable and ultimately result in a more timely operation.…”

Danger points, complications and medico-legal aspects in endoscopic sinus surgery

“…In the year 2000/2001 for instance, nasal packs were still applied in ¾ of patients in Great Britain [45]. In more recent studies nasal packing was not used in about 90% – however, preferably those patients without nasal packing had surgery under local anaesthesia or with low blood loss, without concomitant septal correction and without surgery of the lower turbinates [145], [598], [599]. In about 3% postoperative bleeding occurred and had to be treated secondarily [600].…”