Author(s): Mylanahalli Doddarangaiah Prakash1, Revathy Thirugnanamani2, Aparna Mohan3
Deflected nasal septum (DNS) is the commonest septal problem in ENT practice. The most painful and unpleasant part of this procedure is during removal of nasal pack.
Our study aims to compare the results of septoplasty with and without post-operative nasal packing and thereby assess the necessity of nasal packing after septoplasty in terms of patient’s comfort, effectiveness at controlling the haemorrhage.
In our study, 80 patients who underwent septoplasty in our institution during the period July 2014 till April 2015 were simply randomised into two groups, 1 group received post-operative packing and for the other group of 40 patients, nasal packing was not done and their symptoms assessed and compared on post-operative day 1, after 1 week and 1 month and results were analysed. The following symptoms nasal obstruction, headache, bleeding, irritation of eyes, mouth breathing, running nose, ear ache, fullness, disturbed sleep, loss of smell or taste and crusting were assessed. Patients who underwent septoplasty with turbinectomy or MMA or FESS were excluded from the study.
Among the 80 patients who participated in the study, predominant were males (67.5%) and the predominant age group was 11-20 years. On comparing the nasal symptoms on post-operative day 1, there was significant difference between the study and control groups in the symptoms, headache, nasal obstruction, irritation/watering of eyes, mouth breathing, earache, ear fullness, disturbed sleep, loss of smell/taste, crusting, showed statistically significant difference among both the groups whereas bleeding, nasal discharge were not significant. On comparing the symptoms after one week, nasal obstruction, mouth breathing, crusting and loss of smell had statistically significant values and bleeding and irritation of eyes were not present in both the groups. After one month when the symptoms were compared, none of them were statistically significant.
Nasal packing following septoplasty is thought to stabilise the remaining septum and prevent complications such as bleeding, septal haematoma, and formation of synechiae. Quilting sutures can effectively serve all these purposes. Also helps to avoid post-operative discomfort to the patient and decreases hospital stay. Hence packing can be reserved for special situations rather than using it in all cases.