Comparative study of nasal packs, quilts and splints in septal surgery

<p><strong>Background</strong>: Nasal packing, quilting and splinting are utilized in septal surgery to have a patent airway. The effects on the patient have been studied.</p><p><strong>Materials and Methods: </strong>60 subjects with deviated nasal septum requiring septal surgery were selected from the Rhinology division of otorhinolaryngology services of Dayanand Medical College and Hospital, Ludhiana. Comparison between nasal packing, nasal splints and quilt suturing was carried out in a period of one and a half years.</p><p><strong>Results: </strong>All the 20 patients (100%) of anterior nasal packing had severe local discomfort but no postoperative hematoma. 1 patient (5%) of quilt stitching showed septal swelling in 1 patient (5%) of anterior nasal packing suffered from moderate degree of fever. There was no such episode in any of the patients in whom quilt stitching and splints were used. 6 patients (30%) of anterior nasal packing had crust formation which was not seen in quilt stitching and splint patients. 7 patients (35%) of nasal packing had ulceration of nasal mucosa on removal of pack, while none had in the quilt stitching or nasal splint group. 2 (10%) patients with anterior nasal packing had postoperative synechiae formation.</p><p><strong>Conclusion: </strong>Quilting and splinting are the ideal tamponade post septal intervention As except for mild discomfort they do not experience the unpleasant sequel of accordion nasal packs. Moreover, it makes the procedure a day care surgery.</p>

Effects of preconditioning by nasal splint and mouth breathing on emergence delirium after functional endoscopic sinus surgery in Chinese adults: a study protocol for a randomised controlled trial

IntroductionEmergence delirium (ED) is a common adverse manifestation after general anaesthesia and may result in undesirable consequences. Its causes and mechanisms are diverse and complex, and it is still unavoidable in clinical work. There is a high incidence of ED after otorhinolaryngology surgery, which may result from the sudden loss of functional senses and discomfort of surgical organs. This study aims to test a non-invasive, non-drug treatment modality of nose clamping and mouth-breathing training before surgery to reduce ED.Methods and analysisThis prospective randomised controlled trial (RCT) will include 200 patients who undergo functional endoscopic sinus surgery (FESS) at Shanghai General Hospital, China. Study participants will be randomly assigned in two groups with a 1:1 ratio. The pretreatment group (P-group) will receive an intervention by nasal splint and mouth-breathing training before surgery, while the control group (C-group) will not receive any intervention; following which both groups will undergo FESS under general anaesthesia in accordance with the same anaesthesia scheme. After surgery, we will perform a single-blinded assessment of ED occurrence with stratification. IBM SPSS Statistics V.20 statistical software will be used for statistical analyses. A X2 test will be used to compare the two groups, and t-tests will determine the statistical significance of continuous variables.Ethics and disseminationThis RCT was designed in accordance with the principles of the Declaration of Helsinki and has been approved by the Ethics Committee of Shanghai General Hospital, ID: 2019KY039.We expect to release the original data in February 2022 on the ResMan original data sharing platform (IPD sharing platform) of the China clinical trial registry, which can be viewed at the following website:http://www.medresman.org.cn/pub/cn/proj/projectshow.aspx?proj=6293.Trial registration numberChiCTR1900024925

The Effects of Different Types of Nasal Packing on Odor Function and Mucociliary Function After Septum Surgery

Background: In this study, we evaluated how the Merocel and nasal splint packing placed in the nose after septoplasty surgery affects the olfactory and mucociliary functions of the nose in the early period, and compared the 2 packing with each other. Material and Method: The study included 60 patients with isolated septal deviation and 30 patients in the control group. The patients were randomly divided into 2 groups. Nasal splint was inserted after septoplasty in group A (n = 30). Merocel was inserted in group B (n = 30). The Sniffin sticks test and saccharin test were applied to the patients before surgery and 15 days after the surgery. The same tests were applied to the control group consisting of 30 patients and the results were compared. Results: No complications, such as postoperative bleeding, submucoperichondrial hematoma, or abscess formation, were found in both groups. Mucociliary function was improved after septoplasty, and it was statistically significant, but there was no statistically significant difference between both packing groups. A statistically significant difference was found for the odor test in patients who used nasal splint packing in comparison with patients who used Merocel in the early period. Conclusion: The odor test showed significant differences between the 2 groups and this was statistically significant in the early period. Mucociliary function was better after surgery, but there was no statistical difference in the different nasal packing groups.

A Novel External Nasal Splint

Every year, hundreds of thousands of individuals suffer from nasal bone fractures, and in 2016, more than 780 000 rhinoplasty surgeries were performed globally. As part of the comprehensive care for these patients, external nasal splints are routinely used during the healing process. Nasal splints stabilize the bony and cartilaginous nasal framework and provide compression to the nose, thereby reducing nasal edema and hastening recovery. In this article, we present a novel external nasal splint that addresses some of the shortcomings of other commercially available nasal splints.