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A Comparative Study Between Septal Quilting Sutures Without Nasal Packing and Only Nasal Packing Post-septal Correction

  • Vijay RamalingamEmail author
  • Rajarajan Venkatesan
  • Subramaniam Somasundaram
  • Kamindan Kandasamy
  • Murugesan Rajeswari
Original Article
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Abstract

Septal correction is the commonest surgery by rhinologists worldwide. We aimed at studying the comfort level of the patient with standard postoperative nasal packing with Merocel and placing quilting sutures in septum leaving the nose unpacked in the postoperative period. We conducted the study in the tertiary care centre enrolling 82 patients in a quasi-randomised method of odd and even numbers placing them in the nasal packing group and the quilting group respectively. We used analogue scoring method for subjective assessment of comfort level in the postoperative period and the surgeon objectively assessed the patient on follow up. The results were tabulated and analysed. Postoperative pain, headache and sleep disturbance was significantly more in the nasal packing group. We found that the crusting is commonly seen in patients in the nasal packing group. Quilting the nasal septum and leaving the nasal cavity unpacked increases the comfort level of the patient in the postoperative period. The resultant pain, headache and sleep disturbance caused by nasal packing can be significantly avoided by using quilting the septum without nasal packing. We also observed that by avoiding nasal packing postoperatively, the patients were more comfortable and compliant with the treatment regimen and follow-up.

Keywords

Septal deviation Nasal packing Quilting suture Postoperative 

Notes

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Compliance with Ethical Standards

Conflict of interest

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The authors certify that they have no affiliations with or involvement in any organisation or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical Approval

The author hereby declares that there were no ethical issues involved in the publishing of this article in any journal.

References

  1. 1.
    Benson Mitchel R, Kenyon G (1996) Septoplasty as a day case procedure—a two centred study. J Laryngol Otol 110(2):129–131CrossRefGoogle Scholar
  2. 2.
    Bauman I (2010) Quality of life before and after septoplasty and rhinoplasty. Laryngorhinootology 45:35–45CrossRefGoogle Scholar
  3. 3.
    Low WK, Willat DJ (1992) Submucous resection for deviated nasal septum. Singap Med J 33:617–619Google Scholar
  4. 4.
    Weber R, Hochapfel F, Draf W (2000) Packing and stents in endonasal surgery. Rhinology 38:49–62Google Scholar
  5. 5.
    Hesham A, Ghali A (2011) Rapid Rhino versus Merocel nasal packs in septal surgery. J Laryngol Otol 125(12):1244–1246CrossRefGoogle Scholar
  6. 6.
    Samad I, Stevens HE, Maloney A (1992) The efficacy of nasal septal surgery. J Otolaryngol 21:88–91Google Scholar
  7. 7.
    Naghibzadeh B, Peyvandi AA, Naghibzadeh G (2011) Does post septoplasty nasal packing reduce complications? Acta Med Iran 49(1):9–12Google Scholar
  8. 8.
    Walikar BN, Rashinkar SM, Watwe MV, Fathima A, Kakkeri A (2011) A comparative study of septoplasty with or without nasal packing. Indian J Otolaryngol Head Neck Surg 63(3):247–248CrossRefGoogle Scholar
  9. 9.
    Muhammad IA, Rahman NU (2003) Complications of the surgery for deviated nasal septum. J Coll Physicians Surg Pak 13(10):565–568Google Scholar
  10. 10.
    Sessions RB (1984) Membrane approximation by continuous mattress sutures following septoplasty. Laryngoscope 94:702–703CrossRefGoogle Scholar
  11. 11.
    Cukurova I, Cetinkaya EA, Mercan GC, Demirhan E, Gumussoy M (2012) Retrospective analysis of 697 septoplasty surgery cases: packing versus trans-septal suturing method. Acta Otorhinolaryngol Ital 32:111–114Google Scholar
  12. 12.
    Awan MS, Iqbal M (2008) Nasal packing after septoplasty: a randomized comparison of packing versus no packing in 88 patients. Ear Nose Throat J 87(11):624–627CrossRefGoogle Scholar
  13. 13.
    Jawaid A, Tahir M, Abdullah A, Akbar F, Jamalullah M (2012) Intranasal pressure splints—a reliable alternative to nasal packing in septal surgery. Bangladesh J Otorhinolaryngol 18(2):124–128CrossRefGoogle Scholar
  14. 14.
    Turhan M, Bostancı A, Akdag M, Dinc O (2013) A comparison of the effects of packing or transseptal suture on polysomnographic parameters in septoplasty. Eur Arch Otorhinolaryngol 270(4):1339–1344CrossRefGoogle Scholar
  15. 15.
    Asaka D, Yoshikawa M, Okushi T, Nakayama T, Matsuwaki Y, Otori N, Moriyama H (2012) Nasal splinting using silicone plates without gauze packing following septoplasty combined with inferior turbinate surgery. Auris Nasus Larynx 39(1):53–58CrossRefGoogle Scholar
  16. 16.
    Korkut AY, Teker AM, Eren SB, Gedekli O, Askiner O (2010) A randomised prospective trial of trans-septal suturing using a novel device versus nasal packing for septoplasty. Rhinology 48:179–182CrossRefGoogle Scholar
  17. 17.
    Veluswamy A, Handa S, Shivaswamy S (2011) Nasal septal clips: an alternative to nasal packing after septal surgery? Indian J Otolaryngol Head Neck Surg. 64:1–5Google Scholar
  18. 18.
    Ansari MA, Islam U, Hirani I, Khayani IAM, Kashmiri ZA (2013) Trans-septal suturing technique without intra-nasal packing in nasal septal surgery. Pak J Surg 29(2):123–126Google Scholar
  19. 19.
    Günaydin RÖ, Aygenc E, Karakullukcu S, Fidan F, Celkkanat S (2011) Nasal packing and transseptal suturing techniques: surgical and anaesthetic perspectives. Eur Arch Otorhinolaryngol 268:1151–1156CrossRefGoogle Scholar
  20. 20.
    Thapa N, Pradhan B (2011) Postoperative complications of septal quilting and BIPP packing following septoplasty. J Nepal Health Res Counc 9(19):186–188Google Scholar
  21. 21.
    Kula M, Yuce I, Unlu Y, Tutus A, Cagli S, Ketenci I (2010) Effect of nasal packing and haemostatic septal suture on mucociliary activity after septoplasty: an assessment by rhinoscintigraphy. Eur Arch Otorhinolaryngol 267(4):541–546CrossRefGoogle Scholar
  22. 22.
    Nunez DA, Martin FW (1991) An evaluation of post-operative packing in nasal septal surgery. Clin Otolaryngol Allied Sci 16:549–550CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2019

Authors and Affiliations

  1. 1.KMCH Institute of Health Sciences and ResearchCoimbatoreIndia
  2. 2.TN MGR UniversityChennaiIndia
  3. 3.KFMSRCoimbatoreIndia
  4. 4.JIPMERPondicherryIndia

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