Comparison the Effect of trans-septal suture technique versus the intranasal Merocel packing regarding local nasal pain and sleep disturbances after septoplasty
DOI:
https://doi.org/10.56056/amj.2019.99Keywords:
Intranasal packing, Septoplasty, Trans-septal suturingAbstract
Background and objectives: Nasal septal deviation is corrected by septoplasty which is a common surgical procedure performed by otolaryngologists. Septal surgery may be associated with numerous complications mainly pain. Otolaryngologists frequently pack both nasal cavities with different types of nasal packing to minimize these complications. Nasal packing is associated with some burden on the patient in post-operative days like local pain. To avoid these issues, many surgeons use transseptal [through and through] suturing techniques to overcome the need for packing after surgery. The aim of this study was to compare the effect of the transseptal suture technique versus the intranasal packing regarding local nasal pain and sleep disturbances after septoplasty.
Methods: Prospective comparative study conducted on 120 patients. These patients underwent septoplasty, without additional nasal procedure, for nasal septal deviation. Patients were randomly divided into two equal groups before the operation. Group (A) with trans-septal su- ture technique was compared with group (B) in which intra-nasal packing with Merocel was done which were removed on the second postoperative day. Pain level using visual analog scale postoperatively was recorded over a follow-up period of 1st and 2nd postoperative day.
Results: Out of 120 patients who had classical septoplasty, 74 patients were males (61.7%) and 46 patients were females (38.3%). Patients who had intra-nasal packing got significantly more postoperative pain (P<0.05), Visual analog scale score was significantly higher in group B than those who had trans-septal suture [group A].
Conclusions: Trans-septal suturing technique without nasal packing for septoplasty postoperatively can be safely performed and with minimal local pain and sleep disturbances compared with the intra-nasal packing technique.
Downloads
References
Bauman, Quality of life before and after septoplasty and rhinoplasty. Laryngorhinootologie 2010; 45:35-45.
Benson Mitchel R, Kenyon G. Septoplasty as a day case procedure- a two-centered study. Laryngol Otol. 1996; 110 (2): 129-31.
Berrylin J. Ferguson. Surgical Correction of Nasal Obstruction. In: Myers EN, Operative otolaryngology: Head and neck surgery, Volume 2. 2nd ed. Philadelphia: Elsevier Saunders; 2008. p. 17-26.
Adriaan F Van Olphen. The septum; Hodder Arnold; Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery, UK, Oxford, Blackwell Publishing; 2008. Volume 2. 7th ed.; p. 1569-81.
Low WK, Willat DJ. Submucous resection for deviated nasal septum. Singapore Med.J.1992; 33:617-19.
Barelli PA, Loch EE, Kern EB, Steiner A (eds). Rhinology: the collected writings of Maurice H. Cottle MD. Warwick, NY; American Rhinologic Society, 1987.
Sercer A. Die Dekortikation der Nase. ; Sercer A, Mundlich K (eds). Plastische operation en an der Nase und an der Ohrmuschel. Stuttgart: Thieme, 1962.
Padovan IF. External approach in rhinoplasty (decortication). In: Con- ley J, Dickinson JT (eds). Plastic reconstructive surgery of the face and neck, Stuttgart: Thieme, 1972, Vol. 1; 143-6.
Goodman WS. External approach to rhinoplasty. Canadian Journal of Otolaryngology. 1973; 2: 207-10.
Neal C. Gehani, Steven M. Houser. Septoplasty, Turbinate reduction, and Correction of Nasal Obstruction. In: Jonas T. Johnson, Clark A. Rosen, editors. Bailey’s Head and Neck Surgery-Otolaryngology, Volume 1.5th ed. Philadelphia: Lippincott Williams & Wilkins; 2014. p. 612-21.
Von Schoenberg M, Robinson P, Ryan R. Nasal packing after routine nasal surgery-is it justified? J Laryngol Otol. 1993; 107:902-5.
Weber R, Hochapfel F, Draf W. Packing and stents in endonasal sur- gery. Rhinology 2000; 38:49-62.
Hesham A, Ghali A. Rapid Rhino versus Merocel nasal packs in septal surgery. J Laryngol Otol. 2011; 125(12):1244-6.
Samad I, Stevens HE, Maloney A. The efficacy of nasal septal sur- gery. J Otolaryngol. 1992; 21: 88-91.
Naghibzadeh B, Peyvandi AA, Naghibzadeh G. Does post-septoplasty nasal packing reduce complications? Acta Med Iran. 2011; 49(1):9-12.
Walikar BN, Rashinkar SM, Watwe MV, Fathima A, Kakkeri A.A comparative study of septoplasty with or without nasal packing. Indian J Otolaryngol Head Neck Surg. 2011 Jul; 63(3): 247-8.
Iqbal A Muhammad, Nabil Ur Rahman. Complications of the surgery for deviated Nasal Septum. J Coll Physicians Surg Pak. 2003; 13(10):565-8.
Lemmens W, LemkensP. Septal suturing following nasal septoplasty, a valid alternative for nasal packing? Acta Otorhinolaryngol Belg. 2001; 55: 215-21.
Yilmazer C, Sener M, Yilmaz I, et al. Preemptive analgesia for removal of nasal packing: A double-blind placebo-controlled study. Auris Nasus Larynx. 2007; 34: 471-75.
Veluswamy A, Handa S, Shivaswamy S. Nasal Septal Clips: An Alternative to Nasal Packing After Septal Surgery? Ind J Otolaryngol and Head and Neck Surgery. 2011; 1-5.
Dubin MR, Pletcher SD. Postoperative Packing After Septoplasty: Is It Necessary? Otolaryngol Clin North Am. 2009; 42: 279-85.
Sessions RB. Membrane approximation by continuous mattress su- tures following septoplasty. Laryngoscope. 1984; 94: 702-3.
Lee IN, Vukovic L. Hemostatic suture for septoplasty: How we do it. J Otolaryngol. 1988; 17: 54-6.
Hari C, Marnane C, Wormald PJ. Quilting sutures for nasal septum.
J Laryngol Otol. 2008; 122: 522-23.
Cukurova, E.A. Cetinkaya1, G.C. Mercan, E. Demirhan, M. Gumus- soy. Retrospective analysis of 697 septoplasty surgery cases: packing versus trans-septal suturing method. Acta Otorhinolaryngologica Italica 2012; 32: 111-14.
Awan MS, Iqbal M. Nasal packing after septoplasty: a randomized comparison of packing versus no packing in 88 patients. Ear Nose Throat J. 2008 Nov; 87(11): 624-27.
Turhan M, Bostanc? A, Akdag M, Dinc O. A comparison of the effects
of packing or transseptal suture on polysomnographic parameters in septoplasty. Eur Arch Otorhinolaryngol. 2013; 270(4): 1339–44.
Asaka D, Yoshikawa M, Okushi T, Nakayama T, Matsuwaki Y, Otori N, Moriyama H. Nasal splinting using silicone plates without gauze packing following septoplasty combined with inferior turbinate surgery. Auris Nasus Larynx. 2012; 39(1): 53-8.
Jawaid A, Tahir M, Abdullah A, Akbar F, Jamalullah M. Intranasal pressure splints - a reliable alternative to nasal packing in septal sur- gery. Bangladesh J Otorhinolaryngol. 2012; 18(2): 124-28.
MA Ansari, Umairul Islam, I Hirani,IAM Khayani, ZA Kashmiri. Trans-septal suturing technique without intra-nasal packing in nasal septal surgery. Pak J Surg 2013; 29(2): 123-26.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Said Mustafa Said
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in AMJ (The Scientific Journal of Kurdistan Higher Council of Medical Specialties )is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0)