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Huang X, Gan Y, Xia X, Gu T, Peng S, Wu J, Chen X, Liang Y, Guo Z, Lin J. Submucosal Trans-Septal Suturing Technique After a Septal Extension Graft with Porous High-Density Polyethylene: A Technical Report. Aesthetic Plast Surg 2024:10.1007/s00266-024-04052-8. [PMID: 38831066 DOI: 10.1007/s00266-024-04052-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/09/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Porous high-density polyethylene (pHDPE) is an alternative material for a septal extension graft (SEG) in oriental rhinoplasty when autologous cartilage is limited. Although nasal packing (NP) and trans-septal suturing (TSS) techniques are routine procedures to obviate the dead space after septoplasty, they are associated with certain discomforts and complications. OBJECTIVE To investigate the application of a submucosal trans-septal suturing (STSS) technique after SEG with pHDPE. METHODS A prospective study was conducted on 60 female participants who underwent SEG with pHDPE. The participants were randomly divided into the NP group and STSS group. The extra surgical duration of NP and STSS, pain, nasal obstruction, and sleeping disturbance as well as postoperative complications were recorded and compared between groups. RESULTS No significant difference was found between group NP and group STSS in terms of mean age. The mean extra surgical duration of group STSS was significantly longer than group NP. There were significant higher pains of group NP at 24 hours and 48 hours postoperatively, compared with group STSS. The NP group also experienced significantly more nasal obstruction and sleep disturbance within 48h postoperatively compared to the STSS group. There was one infection in each group, minor bleeding in two NP patients, and one STSS patient. There was no major bleeding, hematoma, graft exposure, or septal perforation in both groups. CONCLUSION Although STSS needs a longer extra surgical duration than NP, it significantly improves the patient's postoperative comfort with a faster return to normal respiration compared to NP. LEVEL OF EVIDENCE I This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Xin Huang
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Yufeng Gan
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Xiaofeng Xia
- Department of Plastic Surgery, Hangzhou Fuyang Hospital of Traditional Chinese Medicine, No.4 Guihua Road, Hangzhou, 311400, Zhejiang, China
| | - Tianya Gu
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Su Peng
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Jie Wu
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Xiang Chen
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Yan Liang
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China
| | - Zongke Guo
- Department of Plastic Surgery, Zhongda Hospital, Southeast University, No.87 Dingjiaqiao, Nanjing, Jiangsu, China.
| | - Jinde Lin
- Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, No.146 Hanzhong Road, Nanjing, 210009, Jiangsu, China.
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Dizdar SK, Doğan U, Ece M, Kaya KS, Seyhun N, Turgut S. Effects of submucoperichondrial application of platelet-rich plasma on nasal mucosal healing after septoplasty. Auris Nasus Larynx 2024; 51:437-442. [PMID: 38520974 DOI: 10.1016/j.anl.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/18/2023] [Accepted: 12/13/2023] [Indexed: 03/25/2024]
Abstract
OBJECTIVE(S) Our aim is to investigate the effects of the submucoperichondrial application of Platelet Rich Plasma (PRP) on nasal mucosal healing after septoplasty surgery. METHOD(S) This prospective randomized observational study was conducted between July 2019 and February 2021, with 40 patients aged 18-60 years who underwent closed the only septoplasty operation for similar septal deviations. Patient divided into two group; 21 patients were placed in PRP group to which PRP was applied on all mucosal surface and submucoperichondrial area of septum and 19 patients were placed in control group to which saline solution was applied on same regions. Nasal obstruction score, mucociliary clearance time, presence of nasal crusting, and bleeding time were evaluated on 5th, 10th, 15th day after surgery and compared between groups. RESULTS Intranasal crusting on day 10 was found to be lower in the PRP group (n:13 68.4 %) than control group (n:7 33.3 %) with a statistically significant difference (p = 0.028). The nasal obstruction score on day 10 and 15 were found to be lower in the PRP group (3,33 ± 2,75, 2,07 ± 2,20) (than the control group (5,44 ± 2,26, 3,37 ± 1,92) with a statistically significant difference (p = 0,003,p = 0,009). The mucociliary clearance rate was found to be higher and the bleeding time was found to be lower in the PRP group, but a statistically significant difference was not observed. CONCLUSIONS Application of submucoperichondrial PRP could have beneficial effects on nasal mucosal repair, nasal crusting, and congestion after septoplasty surgery.
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Affiliation(s)
- Senem Kurt Dizdar
- University of Health Science Hamidiye Sisli Etfal Education and Research Hospital, Otorhinolaryngology Department, Demokrasi Street, Huzur Neighbourhood, No:1, Sarıyer, İstanbul, Turkey.
| | - Uğur Doğan
- University of Health Science Hamidiye Sisli Etfal Education and Research Hospital, Otorhinolaryngology Department, Demokrasi Street, Huzur Neighbourhood, No:1, Sarıyer, İstanbul, Turkey
| | - Mehmet Ece
- University of Health Science Hamidiye Sisli Etfal Education and Research Hospital, Otorhinolaryngology Department, Demokrasi Street, Huzur Neighbourhood, No:1, Sarıyer, İstanbul, Turkey
| | - Kerem Sami Kaya
- University of Health Science Hamidiye Sisli Etfal Education and Research Hospital, Otorhinolaryngology Department, Demokrasi Street, Huzur Neighbourhood, No:1, Sarıyer, İstanbul, Turkey
| | - Nurullah Seyhun
- University of Health Science Hamidiye Sisli Etfal Education and Research Hospital, Otorhinolaryngology Department, Demokrasi Street, Huzur Neighbourhood, No:1, Sarıyer, İstanbul, Turkey
| | - Suat Turgut
- University of Health Science Hamidiye Sisli Etfal Education and Research Hospital, Otorhinolaryngology Department, Demokrasi Street, Huzur Neighbourhood, No:1, Sarıyer, İstanbul, Turkey
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Stępiński MJ, Banaszewski J. Intranasal Synechiae as Complications of Rhinosurgical Treatment-A Review of Current Knowledge. J Clin Med 2023; 12:6831. [PMID: 37959296 PMCID: PMC10648208 DOI: 10.3390/jcm12216831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 11/15/2023] Open
Abstract
Intranasal adhesions (synechiae) develop as a result of improper healing of the nasal mucosa. Their incidence ranges from 6.8% to 36% of rhinosurgical procedures. The aim of this study was to review the available publications and monographs dealing with intranasal adhesions-both in the context of formation and risk factors. The study used a review of the literature to determine the articles and studies available in the following medical databases: MEDLINE (National Library of Medicine's), PubMed, and Google Scholar. The following search terms were used: synechiae nasal + synechial nasal + intranasal adhesions + nasal adhesions. The time criterion of available materials was not applied. Available filters in the search engines were used to narrow down the search results. Artificial intelligence was not applied. The review indicated that the risk of intranasal adhesions correlates with the type of surgery, the surgical technique, the dressing materials, and wound care in the postoperative period. Every case requires an individualized approach. Nasal septum separators, (self-)dissolving dressings and (in selected cases) Mitomycin C were investigated thoroughly. Further studies are required which may result in a universal classification system for intranasal adhesions.
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Affiliation(s)
- Mateusz J. Stępiński
- Department of Laryngology with Maxillofacial Surgery Subdepartment, Multidisciplinary Regional Hospital, Dekerta 1, 66-400 Gorzow Wielkopolski, Poland
| | - Jacek Banaszewski
- Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznan, Poland
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Kim KS, Min HJ. Rare Complication Associated With Dislocation of a Silastic Nasal Splint After Septoplasty: A Case Report. EAR, NOSE & THROAT JOURNAL 2022:1455613221092209. [PMID: 35403462 DOI: 10.1177/01455613221092209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Septoplasty is among the most frequently performed procedures in the field of otorhinolaryngology. Adhesion is known to be the most common complication occurring after septoplasty. Post-surgical insertion of silicone splints is a widely used measure for the prevention of postoperative complications. Recently, we encountered a case where the silicone splint was dislocated and further displaced to the level of the upper esophageal sphincter. Although it was safely removed using fiberoptic gastroendoscopy, delayed removal could have induced other serious sequelae. Since no similar cases have been previously reported, we believe that this may be a very rare complication induced by a loose absorbable suture. Therefore, we suggest that otorhinolaryngologists should pay attention to the fixation of a silicone splint with sutures under appropriate tension to prevent the dislocation of the silicone splint and its subsequent sequelae.
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Affiliation(s)
- Kyung Soo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, 65542Chung-Ang University College of Medicine, Seoul, Korea
| | - Hyun Jin Min
- Department of Otorhinolaryngology-Head and Neck Surgery, 65542Chung-Ang University College of Medicine, Seoul, Korea
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Kastyro IV, Popadyuk VI, Muradov GM, Reshetov IV. Low-Intensity Laser Therapy As a Method to Reduce Stress Responses after Septoplasty. DOKL BIOCHEM BIOPHYS 2021; 500:300-303. [PMID: 34697731 DOI: 10.1134/s1607672921050112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 04/23/2021] [Accepted: 04/25/2021] [Indexed: 11/22/2022]
Abstract
The aim of the study was to evaluate the effectiveness of the use of photobiomodulation therapy (PBMT) to minimize acute pain in the early postoperative period in patients after septoplasty. In total, 62 patients underwent septoplasty under general anesthesia (40 men and 22 women, 18-44 years old) followed by nasal tamponade. Patients of the 1st group did not undergo PBMT, and patients of the 2nd group received PBMT 3, 6, and 24 h after septoplasty (infrared pulsed laser radiation, λ = 0.890 μm, P = 10 W, 2 min in the projection of the wings of the nose). After 48 h, after the removal of tampons, intranasal PBMT with a nozzle in the red range, with λ = 0.63 μm, P = 8 mW, 2 min. ULF, HF, LF, and total power of heart rate variability (HRV), pain syndrome was assessed. ULF, LF, HF, total HRV power were significantly lower in group 2, compared to group 1. In the period from 6 to 24 h after septoplasty, patients of group 1 experienced higher pain than patients with PBMT (p < 0.001). The use of PBMT after septoplasty against the background of nasal tamponade helps to reduce the severity of pain syndrome and the inflammatory response to surgical stress and, consequently, leads to less pronounced changes in the autonomic nervous system in response to surgical stress.
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Affiliation(s)
- I V Kastyro
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russia.
| | - V I Popadyuk
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - G M Muradov
- Peoples' Friendship University of Russia (RUDN University), Moscow, Russia
| | - I V Reshetov
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Abstract
The paper evaluates the effectiveness of the use of therapeutic laser exposure (photobiomodulation therapy – PBMT) to minimize acute pain in the early postoperative period in patients after septoplasty. The study included two groups of patients. Patients of the first group (31 patients) underwent septoplasty with standard management in the postoperative period. Patients of the second group (31 patients) also underwent septoplasty, and then added PBMT to the standard measures of the postoperative period at 3, 6 and 24 h after septoplasty (λ = 0.890 μm, P = 10 W, 2 min) and then intranasally 48 h after septoplasty (λ = 0.630 μm, P = 8 W, 2 min). In patients of both groups, heart rate variability and pain were assessed using a visual analog scale within 48 hours after septoplasty. In patients of the second group, after the use of PBMT, the indicators of heart rate variability had a significantly lower total power, compared with patients of the first group. So, after PBMT, the ultra-low-frequency component of the spectral analysis of heart rate variability in the first group was 18580 ± 2067 ms2, which is significantly higher than in the second group (8086 ± 3003 ms2) (p <0.001). The low-frequency component of heart rate variability was also significantly higher in the first group (1871 ± 405 ms2) compared to the second (1095 ± 190 ms2) (p <0.005), which indicates an increase in the tension of the sympathetic part of the autonomic nervous system in the group without the use of PBMT. In the first 3 hours after surgery, the severity of pain between the groups did not differ significantly (p = 0.07). In the period from 6 to 24 hours after surgery, patients who did not undergo PBMT experienced significantly higher pain than patients with PBMT (p <0.001). Thus, in our study, the group of patients with PBMT showed better results in pain and heart rate variability compared to the classical rehabilitation of patients after septoplasty.
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Titirungruang CK, Charakorn N, Chaitusaney B, Hirunwiwatkul P. Is postoperative nasal packing after septoplasty safe? A systematic review and meta-analysis of randomized controlled studies. Rhinology 2021; 59:340-351. [PMID: 34350430 DOI: 10.4193/rhin21.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To systemically review and compare post-septoplasty complications between total nasal packing and other techniques. METHODOLOGY We searched electronic databases (PubMed, Scopus, and Cochrane Library) and additional sources. The most recent search was on November 30th, 2020. Randomized controlled trials (RCTs) comparing adverse events after post-septoplasty nasal packing versus other techniques were included. The outcomes were adverse events, including respiratory distress, oxygen desaturation, pain severity, bleeding, hematoma, sleep disturbance, infection, crusting, epiphora, dysphagia, perforation, adhesion, and residual septal deviation. RESULTS There were 47 studies (4,087 participants) in this systematic review. Nasal packing was more likely to cause adverse events than other techniques. There were significant increases in respiratory distress, pain, sleep disturbance, crusting, epiphora, dysphagia, and adhesion. There were no statistically significant differences in oxygen desaturation, bleeding, hematoma, infection, perforation, and residual septal deviation. Subgroup analysis found that trans-septal suture was less likely to cause post-operative complications compared with total nasal packing. CONCLUSION Nasal packing after septoplasty was more likely to cause adverse events, including respiratory distress, pain, sleep disturbance, crusting, epiphora, dysphagia, and adhesion. Furthermore, there were no benefits of nasal packing in preventing bleeding, hematoma, and residual septal deviation when compared with other techniques. Routine nasal packing after septoplasty should be avoided. Trans-septal suture should be considered instead.
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Affiliation(s)
- C K Titirungruang
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - N Charakorn
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - B Chaitusaney
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - P Hirunwiwatkul
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Kim SJ, Chang DS, Choi MS, Lee HY, Pyo JS. Efficacy of nasal septal splints for preventing complications after septoplasty: A meta-analysis. Am J Otolaryngol 2021; 42:102389. [PMID: 33482562 DOI: 10.1016/j.amjoto.2020.102389] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/19/2019] [Accepted: 01/03/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND The efficacy of nasal septal splints, which are used as alternatives to nasal packs for preventing complications such as synechia and maintaining septal stability after septoplasty, remains controversial. The present meta-analysis assessed the efficacy and safety of nasal septal splints used after septoplasty. METHODS PubMed and Google Scholar databases were systematically searched until June 20, 2019. Randomized controlled trials or cohort or case-control studies comparing patients who received nasal septal splints with those who did not receive splints after septoplasty were included. Primary outcomes included postoperative pain, infection, bleeding, hematoma formation, synechia, and perforation. Random effects models were used to calculate risk differences and risk ratios with 95% confidence intervals (CIs). RESULTS Thirty-three eligible studies were included. The estimated rate of synechia was significantly lower in the splint group (0.037, 95% CI 0.024-0.056) than in the no splint group (0.087, 95% CI 0.055-0.135; P = 0.003), while visual analog scale scores for pain and the estimated rates of infection, bleeding, hematoma, and perforation were comparable between groups. CONCLUSIONS These findings suggest that the use of nasal septal splints as alternatives or in addition to nasal packing prevent synechia after septoplasty without increasing other complications, including pain, thus adding to evidence supporting the use of septal splints, particularly in cases where postoperative synechia is expected.
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Fang S, Wei X, Ying L, Zhu L, Cui J, Ma Z, Wang W. Comparative study of nasal septal retainer and nasal packing in patients undergoing septoplasty. Eur Arch Otorhinolaryngol 2019; 276:2251-2257. [PMID: 31076882 DOI: 10.1007/s00405-019-05455-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/25/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Nasal packing is frequently used after septoplasty and some complications caused by nasal packing are unavoidable. A nasal septal retainer has recently been developed. We evaluated the safety and clinical efficacy of the retainer in septoplasty, and the subjective symptoms of patients with the retainer were compared with Merocel nasal packing. METHODS A prospective, randomized, controlled study was performed in patients who had undergone septoplasty. In total, 39 patients were randomized to receive Merocel (n = 17) or the retainer (n = 22) after septoplasty. The deviation of nasal septum and nasal mucosa was evaluated by endoscopy. The clinical efficacy and subjective symptoms were compared using the visual analog scale. RESULTS During the packing/retaining period, the mean scores of headache, nasal obstruction, epiphora, and facial pressure in the retainer group were significantly lower than in the Merocel group (P < 0.05); the mean scores of nasal pain, nasal itching, rhinorrhea, dysphagia, and sleep disturbance in the retainer group were lower than in the Merocel group, but the difference did not reach statistical significance. On the removal of Merocel/retainer, nasal pain was significantly lower in patients with the retainer (P < 0.05). In the retainer group, the incidence of grade 1 bleeding was 45.5%, and grade 0 bleeding was 54.5%. In the Merocel group, the incidence of grade 2 bleeding was 23.5%, grade 1 was 47.1%, and grade 0 was 29.4%. CONCLUSIONS The nasal septal retainer is suitable for use after septoplasty with more beneficial effects than nasal packing.
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Affiliation(s)
- Shengjian Fang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Xian Wei
- Department of Otolaryngology-Head and Neck Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Liyun Ying
- Department of Otolaryngology-Head and Neck Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Liwei Zhu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Jiawen Cui
- Department of Otolaryngology-Head and Neck Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Zhaoxin Ma
- Department of Otolaryngology-Head and Neck Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China
| | - Weihua Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China.
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Dadgarnia M, Meybodian M, Karbasi A, Baradaranfar M, Atighechi S, Zand V, Vaziribozorg S. Comparing nasal packing with trans-septal suturing following septoplasty: a randomized clinical trial. Eur Arch Otorhinolaryngol 2017; 274:3513-3518. [PMID: 28685311 DOI: 10.1007/s00405-017-4664-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 06/28/2017] [Indexed: 10/19/2022]
Abstract
It has been shown that nasal packing after septoplasty is associated with several complications. Our aim was to compare post-septoplasty nasal packing and trans-septal suturing, in terms of complications and outcome of operation. This randomized clinical trial was performed on patients with deviated nasal septum who were candidates for septoplasty. Patients were visited three times after operation (on the first 48 h, first week, and third post-operative month). Participants were checked for having common complications. Rhinomanometric evaluation was performed to measure nasal air flow and airway resistance, as indicators of operation efficacy, both prior to and after surgery. A total of 72 patients were allocated into the two trial arms. Patients in nasal pack group reported higher pain scores on the first 48 h (P < 0.001) and one week after surgery (P < 0.001). Epiphora (P = 0.028), sleep disturbance (P = 0.012), and dyspnea (P < 0.001) were also more commonly observed in patients using nasal pack. Objective evaluation of bleeding demonstrated that more severe bleeding occurred in patients with trans-septal sutures (P = 0.001). No differences were found comparing the indices of rhinomanometry between the two groups. Using trans-septal sutures after septoplasty compared to nasal packing, might be associated with lower frequencies of several specific complications and a lower rate of patients' discomfort. Nevertheless, increase in the risk of bleeding and hematoma was noted in the trans-septal suture group. No differences were observed between the nasal air flow and resistance of patients in the two groups.
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Affiliation(s)
- Mohammadhossein Dadgarnia
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mojtaba Meybodian
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Akbar Karbasi
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammadhossein Baradaranfar
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Saeid Atighechi
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Vahid Zand
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sedighe Vaziribozorg
- Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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Kim JS, Kwon SH. Is nonabsorbable nasal packing after septoplasty essential? A meta-analysis. Laryngoscope 2016; 127:1026-1031. [PMID: 27900768 DOI: 10.1002/lary.26436] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Septoplasty is one of the most frequently performed rhinologic surgeries. Complications include nasal bleeding, pain, headache, septal hematoma, synechia, infection, residual septal deviation, and septal perforation. In this study, we aimed to compare complication rates among patients according to packing method. METHODS We performed a literature search using PubMed, Embase, and the Cochrane Library through August 2016. Our systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Random effect models were used to calculate risk differences and risk ratio with 95% confidence intervals (CIs). Cases referred to the nonpacking group included patients treated with transseptal sutures or septal splints. Cases referred to as the packing group included patients treated with nonabsorbable packing such as Merocel or gauze. RESULTS Our search included 20 randomized controlled trials (RCTs) with a total of 1,321 subjects in the nonpacking group and 1,247 subjects in the packing group. There were no significant differences between packing methods regarding bleeding, hematoma, perforation, infection, and residual septal deviation. The risk differences of postoperative pain, headache, and postoperative synechia were -0.50 [95% CI: -0.93 to -0.07, P = .02], -0.42 [95% CI: -0.66 to -0.19, P = .0004], and -0.03 [95% CI: -0.06 to -0.01, P = .01], respectively. CONCLUSIONS Nonabsorbable nasal packing is no more effective than treatments without packing after septoplasty. Septal splints and transseptal sutures reduce postoperative pain, headache, and synechia. LEVEL OF EVIDENCE 1B Laryngoscope, 127:1026-1031, 2017.
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Affiliation(s)
- Jong Seung Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chonbuk National University, Jeonju, Korea
- Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea
| | - Sam Hyun Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chonbuk National University, Jeonju, Korea
- Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Republic of Korea
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Pavlović B, Božić DD, Milovanović J, Jotić A, Djukić V, Djukić S, Konstantinović N, Ćirković I. Quantification of biofilm formation on silicone intranasal splints: An in vitro study. Acta Microbiol Immunol Hung 2016; 63:301-311. [PMID: 27682847 DOI: 10.1556/030.63.2016.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES Biofilms are associated with persistent infections and resistant to conventional therapeutic strategies. The aim of this study was to investigate the quantity of biofilm produced on silicone intranasal splints. METHODS Quantity of biofilm formation on silicone splints (SS) was tested on 15 strains of Staphylococcus aureus and Moraxella catarrhalis, respectively. Antimicrobial susceptibility testing was performed in accordance with European Committee on Antimicrobial Susceptibility Testing recommendations. RESULTS All tested strains formed different amounts of biofilm on SS: 66.7% S. aureus and 93.3% M. catarrhalis were weak biofilm producers and 33.3% S. aureus and 6.7% M. catarrhalis were moderate biofilm producers. S. aureus formed significantly higher quantity of biofilm compared with M. catarrhalis (p < 0.05). Multidrug resistant S. aureus produced significantly higher amount of biofilm compared with non-multidrug resistant strains (p < 0.05). CONCLUSION Quantity of biofilm on SS is highly dependent on bacterial species and their resistance patterns. Future studies are needed to ascertain another therapeutic option for prophylaxis prior to SS placement.
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Affiliation(s)
- Bojan Pavlović
- 1 Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia , Belgrade, Serbia
- 2 Faculty of Medicine, University of Belgrade , Belgrade, Serbia
| | - Dragana D Božić
- 3 Department of Microbiology and Immunology, Faculty of Pharmacy, University of Belgrade , Belgrade, Serbia
| | - Jovica Milovanović
- 1 Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia , Belgrade, Serbia
- 2 Faculty of Medicine, University of Belgrade , Belgrade, Serbia
| | - Ana Jotić
- 1 Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia , Belgrade, Serbia
- 2 Faculty of Medicine, University of Belgrade , Belgrade, Serbia
| | - Vojko Djukić
- 1 Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia , Belgrade, Serbia
- 2 Faculty of Medicine, University of Belgrade , Belgrade, Serbia
| | - Slobodanka Djukić
- 4 Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade , Belgrade, Serbia
| | - Neda Konstantinović
- 4 Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade , Belgrade, Serbia
| | - Ivana Ćirković
- 4 Faculty of Medicine, Institute of Microbiology and Immunology, University of Belgrade , Belgrade, Serbia
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