Abstract
Surgeons have debated since decades on the efficacy or inefficacy of nasal packing yet it is considered routine after septal surgery. Various types of septal splints have been tried as an alternative to nasal packs but most of them need to be sutured around the septum which requires a meticulous approach and expertise. Our aim is to assess and compare the immediate post-operative morbidity and the eventual outcome of septal surgery while using glove finger packs with that of septal clips with splints. This comparative study was done at MCV Memorial ENT Trust Hospital on 80 patients who were diagnosed to have DNS and underwent septal surgery. Patients were divided into two groups. Group A (n = 40) constituted of patients who had glove finger packs and Group B (n = 40) constituted of patients who had septal clips. In the immediate post-operative period patients were assessed for pain, headache, dysphagia, epiphora, dryness of mouth and post-operative bleed. On the first post-operative night, patients were assessed for oxygen saturation. Patients underwent tympanometry just before pack/splint removal and on reviews if the same was abnormal. Post-operative complications like septal perforation and synechiae were noted for both groups and compared. We found that the incidence of pain and various other signs and symptoms was significantly higher in Group A. The difference in the complication rates among the two groups was not statistically significant. We observed that nasal packing is a cause for significant morbidity and discomfort in the immediate post-operative period and does not give any added advantage over septal clips used in our study as far as the final outcome is concerned. Nasal septal clips with splints are a useful alternative to existing techniques of flap approximation after septal surgery. The method is not expensive and needs no special expertise.
Similar content being viewed by others
References
Weber R, Keerl Rainer, Hochapfel F, Draf Wolfgang, Toffel PH (2001) Packing in endonasal surgery. Am J Otolaryngol 22:306–320
Salinger S, Cohen DM (1955) Surgery of the difficult septum. Arch Otolaryngol 419–421
Wright W (1969) Principles of nasal septum reconstruction. Trans Am Acad Ophthalmol 78:252–255
Goode RL (1982) Magnetic intranasal splints. Arch Otolaryngol 108:319
Nayak DR, Murty KD, Balakrishna R (1995) Septal splint with wax plates. J Postgard Med 41(3):70–71
Von Schoenberg M, Robinson P, Ryan R (1993) Nasal packing after routine nasal surgery—Is it justified? J Laryngol Otol 107:902–905
Nunez DA et al (1991) An evaluation of post-operative packing in nasal septal surgery. Clin Otolargyngol 16:549–550
Awan MS, Iqbal M (2008) Nasal packing after septoplasty: a randomized comparison of packing versus no packing in 88 patients. Ear Nose Throat J 87:624
Zwillich CW, Pickett G, Hanson FN et al (1985) Disturbed sleep and prolonged apnoea during nasal obstruction in normal men. Ann Rev Respir Dis 124:158–160
Suratt PM, Turner BL, Wilhoit Sc (1986) Effect of intranasal obstruction on breathing during sleep. Chest 90:324–329
Hady MR, Nodeira KZ, Abdel Hady N (1983) The effect of nasal packing on arterial blood gases and the acid-base balance and its clinical importance. J Laryngol Otol 97:599–604
Thompson AC, Crowther JA (1991) Effect of nasal packing on eustachian tube function. J Laryngol Otol 105:539–540
Egelund E, Jeppesen F (1992) Respiratory tubes with nasal packing following septorhinoplasty. Rhinology 30:193–204
Malki D, Quine SM, Pfleiderer AG (1999) Nasal splints, revisited. J.Laryngol Otol 113:725–727
Norman EJ (1971) Revision surgery of nasal septum. N Y State J Med 2300–2302
Stucker FJ, Ansel DJ (1978) A case against nasal packing. The Laryngoscope 88:1314–1317
Lemmens W, Lemkens (2001) Septal suturing following nasal septoplasty, a valid alternative for nasal packing? Acta Otorhinlaryngol Belg 55:215–221
Daneshrad P, Chin GY, Rice DH (2003) Fibrin glue prevents complications of septal surgery: findings in a series of 100 patients. Ear Nose Throat J 82:1967
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Veluswamy, A., Handa, S. & Shivaswamy, S. Nasal Septal Clips: An Alternative to Nasal Packing After Septal Surgery?. Indian J Otolaryngol Head Neck Surg 64, 346–350 (2012). https://doi.org/10.1007/s12070-011-0388-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-011-0388-2