Bijan Naghibzadeh, Ali Asghar Peyvandi, & Ghazal Naghibzadeh

Does Post Septoplasty Nasal

Reduce Complication
Packings?

Summarized by:
Ebtesam Almajed 439003552, Alya AlZabin 439001489,
Norah Alqntash 439001062, Kayan Alotaibi 439003789
01
BACKGROUND
₪ In otorhinolaryngology, septoplasty is one of the most common nasal procedures
that is performed alone or in conjunction with rhinoplasty.

₪ It was believed that nasal packing could reduce the likelihood of

postoperative complications after septoplasty. According to the authors of the
article, a review of the literature revealed that nasal packs are not clearly
beneficial in improving nasal airways or preventing complications following
septoplasty.

₪ During this randomised clinical trial, two educational hospitals (Imam Khomeini
and Loghman) and private clinics evaluated the advantages and disadvantages
of nasal packing during nasal septoplasty.
₪ Review of the literature revealed that using
nasal packs following septoplasty does not
appear to prevent postoperative complications
or offer any discernible benefits in terms of
improved nasal airway.

₪ In two academic institutions and private clinics,

nasal septoplasty patients were enrolled in
the present randomized clinical trial to evaluate
the benefits and risks of nasal packing.
02
PATIENTS &
METHODS
₪ Patients were divided into two groups, both groups were matched for age and
gender. Standard preoperative laboratory tests were done.

₪ All patients were candidates for the procedure, and septoplasty was carried
out using conventional method under general anaesthesia.

₪ All of the group 1 patients had nasal packing performed using tetracycline-
impregnated gauze, which was removed one or two days following the
procedure.

₪ In contrast, all of the group 2 patients had trans-septal sutures using Vicryl
No. 5 in the traditional way.

₪ Patients are discharged once they have no complaints. The first post operation
visit was the day after surgery, and after that, one week, two weeks, one month,
three months and one year post operatively.
03
STATISTICAL
NOTE
 P-value of
0.05 or less was
considered statistically
significant
04
RESULTS
₪ This trial involved 145 patients, 84 were women and 61 were men. Their ages
ranged between 15 to 63 years.
₪ Who used nasal packing after septoplasty (group 1 n=77) and the others who
did not (group 2 n=68).

Comparison between the findings of follow up visitations in the participants

₪ In (group 1) who had nasal packing: pain, discomfort, nasal obstruction,

nasal breathing, snoring and sleep apnea were the main complaints, especially
pain during pack removal.

₪ Septal hematoma was reported in one case. Septal deviation was repeated in
nine cases, leading to breathing problems in three patients in which revision
septoplasty performed.
₪ Upon follow-up visits in patients without nasal packing (group 2) there were
no toxic shock syndrome, dangerous fungal infection, or septal abscess.

₪ One case of nasal perforation and one case of septal hematoma were reported.
There were two patients who needed nasal packing due to postoperative
haemorrhage.

₪ In one case, synechia and adhesion band were present.

₪ A septal deviation was observed in 11 cases and resulted in breathing problems

in four patients who underwent a second septoplasty.

₪ This group of patients did not suffer from any major problems such as pain,
discomfort, nasal obstruction, nasal breathing, snoring, or sleep apnea.
05
DISCUSSION
₪ According to the results of the study on 145 patients who had septoplasty and
were followed up postoperatively, there were no significant differences
between the two groups, except for the feeling of pain and discomfort (Chi-
square test P>0.05).

₪ However, patients who had nasal packing after septoplasty were not
significantly less likely to experience pain, haemorrhage, or perforation
compared to those without nasal packing.

₪ Postoperative pain is attributed primarily to nasal packing. It is believed by

most patients that the removal of packs is the most painful event. In
septoplasty, suturing the septum is a safe alternative to nasal packing.
 A comparison of nasal packing with suturing was performed on rabbits, but no
significant differences were found. In conclusion, nasal septoplasty can be safely
performed without nasal packing postoperatively. Compared to trans-septal
suturing, nasal packing had no significant advantages.
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THANK
YOU!!