The optimum duration of anterior nasal packing after common nasal surgeries

Abstract

Background Anterior nasal packing (ANP) after nasal surgeries usually causes significant pain and discomfort. Up to the best of our knowledge, there is no evidence accepted for the optimum duration of postoperative ANP. Objective Th aim was to determine the optimum duration for ANP in patients undergoing common nasal surgeries associated with the least discomfort and complications. Patients and methods A prospective randomized clinical study was carried out in Benha University Hospital from November 2018 to August 2019. It included 150 patients who underwent common nasal surgeries: submucosal resection of the nasal septum and/or inferior turbinoplasty or functional endoscopic sinus surgery. Patients were allocated into four groups (A, B, C, and D) according to the duration of ANP (6, 12, 24, and 48 h, respectively). The groups were compared regarding pain during removal of the pack, epiphora, dysphagia, sleep disturbances, bleeding, infection, septal hematoma, septal perforation, crustations, and adhesions. Results Mean pain score was significantly lower in group A and higher in group D. Incidence of epiphora and sleep disturbances before pack removal was significantly lower in group A and higher in group D regardless of the type of surgery, whereas it was not significant regarding dysphagia. Bleeding, infections, crustations, hematoma, adhesions, and septal perforations showed nonsignificant statistical difference among the four groups. Conclusion Early removal of ANP is significantly associated with better patient comfort and less pain and does not increase the incidence of other complications.