R K Weber1, U Hay. 1. Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Marienhospital Stuttgart. rainer-k-weber@t-online.de
Abstract
BACKGROUND: Generally accepted standards regarding the materials which should be used for packing, how long the packing should be left in place or the indications for nasal packing are lacking. Nasal packing is used primarily to control bleeding in endonasal surgery, to stabilize the cartilaginous and bony skeleton and to prevent synechiae or restenosis. For the latter some authors recommend to pack the nose for several days. We want to prove the acceptance according to time, particularly wether there is an increase in discomfort. PATIENTS: Prospective study in 60 patients who underwent septoplasty and submucosal resection of inferior turbinates (n = 30) or endonasal sinus surgery (n = 30, in 15 cases septoplasty was performed too). The nose was packed for 4 or 5 days. Using a visual analog scale (0 - 10) the patient's condition was examined regarding: stuffy nose, headache, sleeping disorders, overall judgement. RESULTS: In two patients the packing had to be removed early (once because of the development of swelling of the lower lid and cheek; once because of lacking acceptance). The average condition of the remaining 58 patients showed no worsening during time for all 4 features. Analyzing the individual, only two patients (3.5 %) showed continuous increasing of complaints. CONCLUSIONS: According to this investigation, nasal packing for 4 or 5 days is well accepted by most of the patients, if you be able to make clear its sense to the patient. Nevertheless, looking for alternative operative techniques or nasal packing materials is mandatory to improve the patient's comfort postoperatively.
BACKGROUND: Generally accepted standards regarding the materials which should be used for packing, how long the packing should be left in place or the indications for nasal packing are lacking. Nasal packing is used primarily to control bleeding in endonasal surgery, to stabilize the cartilaginous and bony skeleton and to prevent synechiae or restenosis. For the latter some authors recommend to pack the nose for several days. We want to prove the acceptance according to time, particularly wether there is an increase in discomfort. PATIENTS: Prospective study in 60 patients who underwent septoplasty and submucosal resection of inferior turbinates (n = 30) or endonasal sinus surgery (n = 30, in 15 cases septoplasty was performed too). The nose was packed for 4 or 5 days. Using a visual analog scale (0 - 10) the patient's condition was examined regarding: stuffy nose, headache, sleeping disorders, overall judgement. RESULTS: In two patients the packing had to be removed early (once because of the development of swelling of the lower lid and cheek; once because of lacking acceptance). The average condition of the remaining 58 patients showed no worsening during time for all 4 features. Analyzing the individual, only two patients (3.5 %) showed continuous increasing of complaints. CONCLUSIONS: According to this investigation, nasal packing for 4 or 5 days is well accepted by most of the patients, if you be able to make clear its sense to the patient. Nevertheless, looking for alternative operative techniques or nasal packing materials is mandatory to improve the patient's comfort postoperatively.