THE USE OF NASAL PACKING & SPLINTS IN SEPTAL SURGERY; IS IT JUSTIFIED
Objective: The objective of this study was to evaluate the no use of nasal packs and nasal septal splints in the postoperative
management of septoplasty and to assess the frequency of postoperative complications such as synechia
formation, septal haematoma, septal perforation & recurrent deviation.
Materials & Methods: Hundred patients who complained of nasal obstruction and underwent septoplasty under
general anesthesia were enrolled in the study in the department of ENT & Head & Neck Surgery at Khyber Teaching
Hospital Peshawar, Pakistan from January 2003 to September 2003. The patients were randomly picked up in outpatient
department in whom septal surgery was indicated as a sample of convenience. All the patients were informed
about the purpose of the study & consent obtained. Standard septoplasty procedure was performed in all cases &
quilting sutures were taken through the septum instead of splints & packs to appose the flaps. A follow-up visit was
scheduled two weeks & then two months after surgical procedure to observe any recurrent deviation, synechia, septal
haematoma, & septal perforation.
Results: We found that majority of the patients were males & majority of the patients were in their twenties or thirties.
Indication of surgery was symptomatic deviation of the septum. Septoplasty was the procedure. The flaps were stitched
in 80% cases. In the remaining 20% a small ribbon gauze pack impregnated with emollient antibiotic ointment was
put on each side for a few hours. 15% cases had deviation, 08% had haematoma 05% had synechia and 04% of the
patients had to be packed in immediate post operative period due to reactionary bleeding. 31% of the patients never
turned up for follow up.
Conclusion: Although our data did not reach statistical significance because of big dropout & small sample size, our
study and previous reports support a better quality of life by not using nasal packs and intranasal splints in septoplasty