Comparing nasal packing with trans-septal suturing following septoplasty: a randomized clinical trial

• Published in: European archives of oto-rhino-laryngology Vol. 274; no. 9; pp. 3513 - 3518
• Main Authors: Dadgarnia, Mohammadhossein, Meybodian, Mojtaba, Karbasi, Akbar, Baradaranfar, Mohammadhossein, Atighechi, Saeid, Zand, Vahid, Vaziribozorg, Sedighe
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2017
• Subjects: Adult; Bandages; Female; Head and Neck; Head and Neck Surgery; Humans; Male; Medicine; Medicine & Public Health; Nasal Septum - surgery; Neurosurgery; Nose Deformities, Acquired - surgery; Otorhinolaryngology; Postoperative Care - methods; Postoperative Hemorrhage - diagnosis; Postoperative Hemorrhage - therapy; Rhinomanometry; Rhinoplasty - adverse effects; Suture Techniques - instrumentation; Sutures; Nasal packing; Complication; Septoplasty; Trans-septal suture
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-017-4664-y

It has been shown that nasal packing after septoplasty is associated with several complications. Our aim was to compare post-septoplasty nasal packing and trans-septal suturing, in terms of complications and outcome of operation. This randomized clinical trial was performed on patients with deviated nasal septum who were candidates for septoplasty. Patients were visited three times after operation (on the first 48 h, first week, and third post-operative month). Participants were checked for having common complications. Rhinomanometric evaluation was performed to measure nasal air flow and airway resistance, as indicators of operation efficacy, both prior to and after surgery. A total of 72 patients were allocated into the two trial arms. Patients in nasal pack group reported higher pain scores on the first 48 h ( P  < 0.001) and one week after surgery ( P  < 0.001). Epiphora ( P  = 0.028), sleep disturbance ( P  = 0.012), and dyspnea ( P  < 0.001) were also more commonly observed in patients using nasal pack. Objective evaluation of bleeding demonstrated that more severe bleeding occurred in patients with trans-septal sutures ( P  = 0.001). No differences were found comparing the indices of rhinomanometry between the two groups. Using trans-septal sutures after septoplasty compared to nasal packing, might be associated with lower frequencies of several specific complications and a lower rate of patients’ discomfort. Nevertheless, increase in the risk of bleeding and hematoma was noted in the trans-septal suture group. No differences were observed between the nasal air flow and resistance of patients in the two groups.