Comparison of Trans-septal Suturing Technique With Polyvinyl Alcohol Sponge-Based Nasal Packing for Hemostasis in Septoplasty.

Abstract

IntroductionDespite the theoretical advantages of bleeding control, there is increased morbidity in postoperative pain, sleep disturbance, allergy, toxic shock syndrome, and mucosal injury with the nasal packing in septoplasty procedure for deviated nasal septum. Trans-septal suturing after septoplasty has been advocated as an effective alternative to conventional nasal packing. The current study aims to compare the frequency of subjective symptoms, such as postoperative nasal pain, nasal bleeding, postnasal drip, sleep disturbance, dysphagia, headache, and epiphora between the trans-septal suturing technique and nasal packing in septoplasty surgery.MethodsWe prospectively recruited all adult septoplasty patients for a one-year duration. Trans-septal nasal suturing was done for hemostasis after septoplasty in the case group. Anterior nasal packing after septoplasty was performed in the control group. The postoperative subjective symptoms were evaluated, such as postoperative nasal pain, nasal bleeding, postnasal drip, sleep disturbance, dysphagia, headache, and epiphora. Procedure-related complications were compared between the two groups.ResultsA total of 50 patients were recruited for the study (25 in each group). The postoperative symptoms evaluation suggested that the number of patients with postoperative pain was significantly higher in the control group on both occasions. Besides pain, a significantly higher number of patients in the control group had symptoms of nasal bleeding, postnasal drip, sleep disturbance, dysphagia, headache, and epiphora.ConclusionTrans-septal suture technique is an effective alternative to nasal packing with a low risk of nasal pain, bleeding, postnasal drip, epiphora, headache, dysphagia, and sleep disturbance. In addition, there is a low risk of complications like nasal bleeding, septal hematoma, septal perforation, and synechiae formation. The only disadvantage of trans-septal suturing compared to PVA-coated nasal packing is the increase in the operative time.