Isam M Al-Shareda* & Ghanem Sikhi Ghanem#
*MBChB, FICMS, Assist. Prof. of Otolaryngology, Dept. of Surgery, College of Medicine, Basrah University. #MB,ChB, CABS, Basrah General Hospital, Basrah, IRAQ.
Nasal packing is carried out in many nasal surgeries specially in septoplasty for hemostasis and internal stabilization of the cartilaginous & bony skeleton of the nose. However, these packing methods are not a harmless procedures and for this reason their benefit has been tested.
The study was performed to compare the use of plastic intranasal splints with or without anterior nasal packing to determine the need of nasal packing after septoplasty.
This is a prospective comparative study which was carried out in Basrah General Hospital, Otolaryngology Department, Basrah, Iraq in the period from July 2014 to April 2015.
Forty seven patients of different age and gender groups were included in the study. Analysis was done regarding their history and examination including nasendoscopy which was done before septoplasty. The patients were randomly selected at the end of the procedure into two groups; one had plastic intranasal splints without anterior packing and the other had plastic intranasal splints with two different types of packing materials (ribbon gauze impregnated with Vaseline and glove fingers). Patients were compared for postoperative pain, headache, discomfort, bleeding, sleep difficulty, epiphora, septal hematoma on the day of the operation, 24 hours and 48 hours postoperatively. The collected data was analyzed by using SPSS v.17.
The age of patients in this study ranged from 18 to 44 years with mean age of (29.6±6.2) years and most of them were between 28 to 37 years (48.9%). Among those 47 patients, 28 (59.6%) were males and 19 (40.4%) were females with male:female ratio was 1.47:1.
Pain, headache, discomfort and bleeding was higher in patients in group two with anterior nasal packing materials especially during removal of the packing. there was significant reduction in the frequency of sleep disturbance, epiphora among the patients in group one without nasal packing, however there was no significant difference in septal hematoma between two groups.
In conclusion, the plastic intranasal splints can be used alone without the need of anterior nasal packing materials after septoplasty as it can be considered as a type of packing methods that offers the advantages of elimination of pain and discomfort and reduce the complications of packing. The anterior nasal packing should be reserved only for selected cases.