Comparative study of nasal septal retainer and nasal packing in patients undergoing septoplasty

Eur Arch Otorhinolaryngol. 2019 Aug;276(8):2251-2257. doi: 10.1007/s00405-019-05455-z. Epub 2019 May 10.

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.

Keywords: Merocel; Nasal obstruction; Nasal packing; Nasal septal retainer; Pain; Septoplasty.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Endoscopy / methods
  • Female
  • Formaldehyde / therapeutic use*
  • Hemostatics / therapeutic use
  • Humans
  • Male
  • Nasal Cavity / diagnostic imaging
  • Nasal Obstruction* / diagnosis
  • Nasal Obstruction* / etiology
  • Nasal Obstruction* / prevention & control
  • Nasal Septum / surgery*
  • Nasal Surgical Procedures* / adverse effects
  • Nasal Surgical Procedures* / methods
  • Occlusive Dressings / adverse effects
  • Polyvinyl Alcohol / therapeutic use*
  • Postoperative Hemorrhage* / diagnosis
  • Postoperative Hemorrhage* / prevention & control
  • Treatment Outcome

Substances

  • Hemostatics
  • Formaldehyde
  • polyvinyl alcohol formaldehyde foam
  • Polyvinyl Alcohol