Comparison the Effect of trans-septal suture technique versus the intranasal Merocel packing regarding local nasal pain and sleep disturbances after septoplasty

Abstract

Background and objectives: Nasal septal deviation is corrected by septoplasty which is a common surgical procedure performed by otolaryngologists. Septal surgery may be associated with numerous complications mainly pain. Otolaryngologists frequently pack both nasal cavities with different types of nasal packing to minimize these complications. Nasal packing is associated with some burden on the patient in post-operative days like local pain. To avoid these issues, many surgeons use transseptal [through and through] suturing techniques to overcome the need for packing after surgery. The aim of this study was to compare the effect of the transseptal suture technique versus the intranasal packing regarding local nasal pain and sleep disturbances after septoplasty. Methods: Prospective comparative study conducted on 120 patients. These patients underwent septoplasty, without additional nasal procedure, for nasal septal deviation. Patients were randomly divided into two equal groups before the operation. Group (A) with trans-septal su- ture technique was compared with group (B) in which intra-nasal packing with Merocel was done which were removed on the second postoperative day. Pain level using visual analog scale postoperatively was recorded over a follow-up period of 1st and 2nd postoperative day. Results: Out of 120 patients who had classical septoplasty, 74 patients were males (61.7%) and 46 patients were females (38.3%). Patients who had intra-nasal packing got significantly more postoperative pain (P<0.05), Visual analog scale score was significantly higher in group B than those who had trans-septal suture [group A]. Conclusions: Trans-septal suturing technique without nasal packing for septoplasty postoperatively can be safely performed and with minimal local pain and sleep disturbances compared with the intra-nasal packing technique.