Comparative study of nasal packs, quilts and splints in septal surgery
Keywords:Nasal packs, Quilting and splinting, Septal surgery
Background: Nasal packing, quilting and splinting are utilized in septal surgery to have a patent airway. The effects on the patient have been studied.
Methods: 60 subjects with deviated nasal septum requiring septal surgery were selected from the Rhinology division of otorhinolaryngology services of Dayanand Medical College and Hospital, Ludhiana. Comparison between nasal packing, nasal splints and quilt suturing was carried out in a period of one and a half years.
Results: All the 20 patients (100%) of anterior nasal packing had severe local discomfort but no postoperative hematoma. 1 patient (5%) of quilt stitching showed septal swelling and 1 patient (5%) of anterior nasal packing suffered from moderate degree of fever. There was no such episode in any of the patients in whom quilt stitching and splints were used. 6 patients (30%) of anterior nasal packing had crust formation which was not seen in quilt stitching and splint patients. 7 patients (35%) of nasal packing had ulceration of nasal mucosa on removal of pack, while none had in the quilt stitching or nasal splint group. 2 (10%) patients with anterior nasal packing had postoperative synechiae formation.
Conclusion: Quilting and splinting are the ideal tamponade post septal intervention As except for mild discomfort they do not experience the unpleasant sequel of accordion nasal packs. Moreover, it makes the procedure a day care surgery.
Balikci HH, Gurdal MM, Celebi S, Ozbay I, Karakas M. Relationships among concha bullosa, nasal septal deviation, and sinusitis: Retrospective analysis of 296 cases. Ear Nose Throat J. 2016;95(12):487-91.
M Sloth, L Kolendorf. Late complications after septum surgery. Ugeskrift for laeger.1976.
Fjermedal O, Saunte C, Pedersen S. Septoplasty and/or submucous resection? 5 years nasal septum operations. JLO.1988;102:796- 8.
Becker H. paraffinoma as a complication of nasal packing. Plast Reconstr Surg. 1983;72:735-6.
Schoenberg M, Robinson P, Ryan R. Nasal packing after routine nasal surgery-Is it justified? J Laryngol Otol. 1993;107:902-5.
Nunez DA, Martin FW. An evaluation of post-operative packing in nasal septal surgery. Clin Otolargyngol. 1991:16(6):549-50.
Nayak DR, Murty KD, Balakrishna R. Septal splint with wax plates. J Postgard Med. 1995;41(3):70-1.
Awan MS, Iqbal M. Nasal packing after septoplasty: a randomized comparison of packing versus no packing in 88 patients. Ear Nose Throat J 2008;87:624
Veluswamy A, Handa S, Shivaswamy S. Nasal septal clips: an alternative to nasal packing after septal surgery? Indian J Otolaryngol Head Neck Surg. 2012;64(4):346-50.
Egelund E, Jeppesen F. Respiratory tubes with nasal packing following septorhinoplasty. Rhinology. 1992;30:193-204.
Campbell J.B., Watson. M.G. and Shenol P.M. The role of intranasal splints in the prevention of postoperative nasal adhesions. JLO. 1987;101:1140-3.
Cook TA, Komorn R.N. Statistical analysis of the alterations of the blood gases produced by nasal packing. The Laryngoscope. 1973;83:1802-7.
Malki D, Quine SM, Pfleiderer AG. Nasal splints, revisited. J Laryngol Otol. 1999;113:725-7.
Sessions RB. Membrane approximation bycontinuous mattresses sutures following septoplasty. Laryngoscope. 1984;94:702.
Bahman Guyron. Is packing after septorhinoplasty necessary? A randomized study. From the Division of Plastic surgery at Mount Sinai Medical Centre, Received for publication.1988.
Reiter Eugene Alford and ZavenJabourian. Alternatives to packing to septorhinoplasty. Arch Otolaryngol Head Neck Surg. 1989;115:1203-5.
Lemmens W, Lemkens Septal suturing following nasal septoplasty, a valid alternative for nasal packing? Acta Otorhinlaryngol Belg. 2001;55:215-21.
Wadhera R, Zafar N, Gulati SP, Kalra V, Ghai A. Comparative study of intranasal septal splints and nasal packs in patients undergoing nasal septal surgery. ENT J. 2014;93(9):396-408.
Daneshrad P, Chin GY, Rice DH. Fibrin glue prevents complications of septal surgery: findings in a series of 100 patients. ENT J. 2003;82:1967.
Hayward PJ, Mackay IS. Fibrin glue in nasal septal surgery. JLO. 1987;101:133-8.
Siedentop KH, Harris DM Sanchez B. Autologous fibrin tissue adhesive. Laryngoscope. 1985;95:1074-9.