Toxic Shock Syndrome Related to Nasal Packing

Hull, Harry F.; Mann, James; Sands, C. J.; Gregg, Stacie; Kaufman, P W

doi:10.1001/archotol.1983.00800230060015

Cited by 71 publications

(33 citation statements)

References 12 publications

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“…5,9,12,21,23 Unusual infections incidentally reported in septorhinoplasty are toxic shock syndrome, septicemia, endocarditis, meningitis, cavernous sinus thrombosis, or even brain abscess formation. 12,[13][14][15]19 All of these infections with systemic or intracranial involvement start in the nasal cavities and then spread by means of the valveless angular, facial, frontal, or supraorbital veins into the cerebral venous sinuses. Most of these serious infections can be prevented by prompt and aggressive treatment of the initial minor infection; early removal of nasal packings and splints is the major nidus of infections.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14][15][16] In most of these cases, the complications were the result of prolonged nasal packing and splinting or caused by allergic reactions to the packing materials or antibiotics. 9,11,15,[17][18][19][20][21] The present literature, however, has failed to show that routine antibiotics reduce the incidence of these serious complications in nasal surgery. 2,8,22 Thus, the use of antibiotic prophylaxis is being questioned increasingly, especially in the context of the increasing occurrence of antibiotic resistance, the side effects of antibiotics, and the rising treatment costs.…”

mentioning

confidence: 99%

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Antibiotic Prophylaxis in Septorhinoplasty? A Prospective, Randomized Study

Rajan

Fergie

Fischer

et al. 2005

Plastic and Reconstructive Surgery

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Antibiotic Prophylaxis in Septorhinoplasty? A Prospective, Randomized Study

Rajan

Fergie

Fischer

et al. 2005

Plastic and Reconstructive Surgery

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“…It is known that nasal packings cause significant local bacterial colonization and release of toxins, leading to toxic shock syndrome. 14 According to guidelines by the AHA and the literature published, our patient had a very low risk of IE after anterior nasal packing. Unfortunately, our patient developed endocarditis despite the use of impregnated nasal packing and oral antibiotics.…”

Section: Discussionmentioning

confidence: 66%

Infective Endocarditis of Native Valve After Anterior Nasal Packing

Jayawardena

Eisdorfer²,

Indulkar³

et al. 2006

American Journal of Therapeutics

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We present a case report of a patient who was previously treated for spontaneous epistaxis with a petroleum jelly gauze (0.5 in x 72 in) anterior nasal packing filled with an antibiotic ointment, along with prophylactic oral clindamycin. The patient presented with fever and hypotension 3 days after the nasal packing. Her blood cultures grew methicillin-resistant Staphylococcus aureus and the transesophageal echocardiography showed vegetation on the atrial surface of the posterior mitral valve leaflet, confirming the diagnosis of bacterial endocarditis attributable to nasal packing. Several case reports discuss toxic shock syndrome after nasal packing, but none describe endocarditis of the native heart valves subsequent to anterior nasal packing. Current guidelines on endocarditis prophylaxis produced by the American Heart Association, European Cardiac Society, and British Cardiac Society together with published evidence do not recommend endocarditis prophylaxis for patients with native heart valves undergoing anterior nasal packing.

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“…In addition to causing discomfort for patients, since the packing is left in the nose for 24 to 72 hours, studies show that the intranasal packing reduces oxygen saturation and can lead to toxic shock syndrome. 5 In addition to packing, flat splints are often placed in the nostrils on each side of the septal wall to prevent fibrous growth that could potentially cause nasal synechia as a result of a needle tearing and pushing or pulling mucosa cells into the nasal cavity during suturing. The investigators measured, as part of an IRB study, the thicknesses of septal tissue, both pre-and post-operatively, during septoplasty surgery for twelve patients.…”

Section: Target Procedure-coaptation Of Mucoperichondrial Flapsmentioning

confidence: 99%

A laser device for fusion of nasal mucosa

Sooklal¹,

McClure²,

Hooper³

et al. 2010

Photonic Therapeutics and Diagnostics VI

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A prototype device has been created to fuse septal tissue membranes as an alternative to sutures or staples through the controlled application of laser heating and pressure to induce protein denaturation and subsequent tissue fusion, through renaturation and intertwining, across the interface. Lasers have been used to close wounds in controlled laboratory tests over the last 15 years. Many encouraging results have been obtained; however, no commercial delivery systems are currently available. This is due primarily to two factors: requiring an inordinate amount of experience on the part of the operator, and attempting to achieve general applicability for multiple tissue systems. The present device overcomes these barriers as it is tailored for the particular application of septal laser fusion, namely for the coaptation of mucoperichondrial membranes.The important parameters involved in fusing biological tissues are identified. The development of the device followed from computational modeling based on Monte Carlo simulation of photon transport and on engineering firstprinciples. Experiments were designed and analyzed using orthogonal arrays, employing a subset of the relevant parameters, i.e., laser irradiance, dwell time and spot size, for a range of wavelengths. The in vitro fusion experiments employed 1cm by 1cm sections of equine nasal mucosa having a nominal thickness of 1mm.

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Toxic Shock Syndrome Related to Nasal Packing

Cited by 71 publications

References 12 publications

Antibiotic Prophylaxis in Septorhinoplasty? A Prospective, Randomized Study

Antibiotic Prophylaxis in Septorhinoplasty? A Prospective, Randomized Study

Infective Endocarditis of Native Valve After Anterior Nasal Packing

A laser device for fusion of nasal mucosa

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