Safety of (rhino)septoplasty without nasal packing in routine ENT practice

Eur Arch Otorhinolaryngol. 2021 Nov;278(11):4329-4333. doi: 10.1007/s00405-021-06713-9. Epub 2021 Mar 18.

Abstract

Purpose: This retrospective study assesses the risks and benefits linked to the non-use of nasal packing after a (rhino)septoplasty, compared with post-operative care with anterior nasal packing such as Merocel®.

Methods: Complication rates observed during the first week after surgery were compared between groups with and without use of classic nasal packing over a large sample of 534 patients, who had undergone either a closed or open procedure, with bilateral turbinoplasty, and with or without osteotomies. Complications listed include epistaxis, haematoma, impetiginization, septal perforation, hyperalgesia, and dyspnoea.

Results: No significant difference was observed between the group with and without packing regarding the immediate post-operative complications of epistaxis (4.4% of the cases with nasal packing versus 3% without, p = 0.918) and impetiginization (3% of the cases with nasal packing versus 4.2% without, p = 0.478). The technique used, as well as any osteotomies performed, had no impact on the results.

Conclusion: Non-use of nasal packing after a (rhino)septoplasty is a safe alternative to classic post-operative methods. Provided that there is a rigorous surgical technique and strict clinical control, it should be used as a principal technique in any routine practice due to its safety for patients immediately post-surgery.

Keywords: Nasal packing; Nasal splints; Postoperative complications; Septoplasty.

MeSH terms

  • Epistaxis* / etiology
  • Epistaxis* / prevention & control
  • Humans
  • Nasal Septum / surgery
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / prevention & control
  • Retrospective Studies
  • Rhinoplasty* / adverse effects