Septoplasty with or without post-operative nasal packing

Introduction:

Septoplasty (SP) is one of the most frequently performed surgical interventions by otorhinolaryngologists when treating symptomatic septal deviation. Nasal packing and placement of medical splints are routinely used after SP. Still, postoperative management varies greatly depending on the ENT surgeons' discretion. The main reason for nasal packing after SP is to prevent postoperative bleeding, while the purpose of using splints is to stabilize the septum in the midline.

Methods:

A literature review was performed with emphasis on the keywords-septoplasty, postoperative care, nasal packing, splints. From the 28 reviewed articles, 9 met our criteria and were included in the analysis. Fifty patients, that underwent SP in the clinic were divided into two groups according to the placement of both nasal tampons and splints, and the other of using only splints. Group one-18 patients without nasal packing and Group two-32 patients with both nasal packing and splints. Early and late complications were assessed. The patients' pain and discomfort levels was also evaluated by a scoring scale from 1 to 10.

Results:

Our practical experience confirmed what the literature review initially pointed at-nasal packing has no significant benefits for the patients' recovery. SP can be safely performed without postoperative nasal packing as there is a small amount of cases requiring placement of nasal tampons.

Conclusion:

The incidence of haemorrhages following septoplasty without nasal packing is very low. No widely accepted practice is established for the usage of nasal packing. This study proves that SP without nasal packing is more convenient and patient-friendly in the postoperative period and has various advantages to the opposite approach.

Publication History

Publication Date:
23 April 2019 (online)