- Email: [email protected]
Effect of nasal packs in septoplasty
Effect of nasal packs in septoplasty Erkan Eski MD, Ismail Yilmaz MD PII: DOI: Reference:
S0196-0709(15)00101-5 doi: 10.1016/j.amjoto.2014.12.012 YAJOT 1579
To appear in:
American Journal of Otolaryngology–Head and Neck Medicine and Surgery
Received date: Accepted date:
11 December 2014 28 December 2014
Please cite this article as: Eski Erkan, Yilmaz Ismail, Effect of nasal packs in septoplasty, American Journal of Otolaryngology–Head and Neck Medicine and Surgery (2015), doi: 10.1016/j.amjoto.2014.12.012
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT Effect of nasal packs in septoplasty
T
Letter to editor
RI P
Erkan Eski, MD, Assistant Professor of Otolaryngology, Baskent University Zubeyde Hanim Practice and Research Center, Department of Otolaryngology Izmir,Turkey
SC
[email protected]
Ismail Yilmaz, MD, Professor of Otolaryngology, Baskent University Faculty of
Please send all correspondence to :
MA NU
Medicine, Department of Otolaryngology, Adana, Turkey, [email protected]
AC
CE
PT
ED
Erkan Eski Baskent University Zubeyde Hanım Training and Research Center Department of Otolaryngology 6371 sk. No.34 Bostanlı/Karşıyaka Izmir- Turkey Fax :902323369421 Phone :902323305230 E-mail :[email protected]
ACCEPTED MANUSCRIPT Effect of nasal packs in septoplasty To the editor, Nasal packing is widely used in nasal surgeries, such as septoplasty and septorhinoplasty, in
T
order to maintain hemostasis, inhibit hematoma, prevent nasal synechia and support septal
RI P
flap. Nasal packs are produced in various types. An ideal nasal pack should be hemostatic and absorbable, and it should not exert any negative effect on wound healing. Negative effects
SC
of the nasal packs on quality of life have been shown before. The most common morbidity
MA NU
associated with nasal packs is postoperative pain [1]. But the use of nasal packing has been proposed to minimize postoperative complications such as hemorrhage, formation of synechiae and septal hematoma. The use of septal splints is also associated with increased postoperative pain. The routine use of septal splint or any nasal packs does not appear to
ED
decrease postoperative complications or improve surgical outcomes when compared less morbid techniques, such as pack free septoplasty [2]. A study by Deniz et al. compared
PT
different nasal packs on postoperative complications was recently published in your journal. I
CE
have read their study with great interest. They reported %19.71 nasal synechia and % 11.26 septal perforation in the Merocel packing group whereas no synechia and %10.16 septal
AC
perforation in the intranasal splint group. Even if they had been mentioned trans-septal suturing technique, had not been discussed enough [3]. The height of this ratio is noteworthy. The incidence of septal perforation varied from 0% to 30.4% for submucous resections [4]. In particular, in the same manner in both groups have high perforation rates appears to be associated with the surgical technique used rather than the pack or splint effect. Surgery and follow-up was done by the same surgeon and used Killian incision is stated in the article. In surgery, entering with Cottle’s hemitransfixion incision instead of Killian’s could both provides surgical field dominance and reduce dechirur rates. Dechirur is important factor
ACCEPTED MANUSCRIPT in the formation of perforation. Furthermore, removed cartilage and bone tissues placed again after crushed suitable are effective in preventing the perforation during septoplasty.
T
In our clinic, pack-free and trans-septal suturing technique is routinely applied and
RI P
recommended in septoplasty. Generally this technique does not cause any problem, if the patients are followed well. In our practice, we did not encounter perforation as we replaced
SC
and did not damage the tissues [5]. It should not been forgotten that pack free technique is the
MA NU
most comfortable for the patients.
*No
AC
CE
PT
ED
References [1] Shinkwin CA, Beasley N, Simo R, Rushton L, Jones NS.Evaluation of Surgicel Nu-knit, Merocel and Vasolene gauze nasal packs: a randomized trial. Rhinology 1996;34(11):41-43. [2] Dubin MR, Pletcher SD. Postoperative packing after septoplasty: is it necessary? Otolaryngol Clin North Am. 2009;42(2):279-285. [3]Deniz M, Ciftci Z, Isık A, Demirel OB, Gultekin E. The impact of different nasal packings on postoperative complications. Am J Otolaryngol 2014:35;554-557. [4] Tzadik A, Gilbert SE, Sade J. Complications of submucous resections of the nasal septum. Arch Otorhinolaryngol 1988:245(2);74-76. [5] Eski E, Adadan I, Hızal E, Yılmaz I. Effect of nasal pack use on surgical success in septoplasty. The Turkish journal of ear nose throat 2014;24(4):206-210
sponsorships or competing interests have been disclosed for this article.
S0196-0709(15)00101-5 doi: 10.1016/j.amjoto.2014.12.012 YAJOT 1579
To appear in:
American Journal of Otolaryngology–Head and Neck Medicine and Surgery
Received date: Accepted date:
11 December 2014 28 December 2014
Please cite this article as: Eski Erkan, Yilmaz Ismail, Effect of nasal packs in septoplasty, American Journal of Otolaryngology–Head and Neck Medicine and Surgery (2015), doi: 10.1016/j.amjoto.2014.12.012
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT Effect of nasal packs in septoplasty
T
Letter to editor
RI P
Erkan Eski, MD, Assistant Professor of Otolaryngology, Baskent University Zubeyde Hanim Practice and Research Center, Department of Otolaryngology Izmir,Turkey
SC
[email protected]
Ismail Yilmaz, MD, Professor of Otolaryngology, Baskent University Faculty of
Please send all correspondence to :
MA NU
Medicine, Department of Otolaryngology, Adana, Turkey, [email protected]
AC
CE
PT
ED
Erkan Eski Baskent University Zubeyde Hanım Training and Research Center Department of Otolaryngology 6371 sk. No.34 Bostanlı/Karşıyaka Izmir- Turkey Fax :902323369421 Phone :902323305230 E-mail :[email protected]
ACCEPTED MANUSCRIPT Effect of nasal packs in septoplasty To the editor, Nasal packing is widely used in nasal surgeries, such as septoplasty and septorhinoplasty, in
T
order to maintain hemostasis, inhibit hematoma, prevent nasal synechia and support septal
RI P
flap. Nasal packs are produced in various types. An ideal nasal pack should be hemostatic and absorbable, and it should not exert any negative effect on wound healing. Negative effects
SC
of the nasal packs on quality of life have been shown before. The most common morbidity
MA NU
associated with nasal packs is postoperative pain [1]. But the use of nasal packing has been proposed to minimize postoperative complications such as hemorrhage, formation of synechiae and septal hematoma. The use of septal splints is also associated with increased postoperative pain. The routine use of septal splint or any nasal packs does not appear to
ED
decrease postoperative complications or improve surgical outcomes when compared less morbid techniques, such as pack free septoplasty [2]. A study by Deniz et al. compared
PT
different nasal packs on postoperative complications was recently published in your journal. I
CE
have read their study with great interest. They reported %19.71 nasal synechia and % 11.26 septal perforation in the Merocel packing group whereas no synechia and %10.16 septal
AC
perforation in the intranasal splint group. Even if they had been mentioned trans-septal suturing technique, had not been discussed enough [3]. The height of this ratio is noteworthy. The incidence of septal perforation varied from 0% to 30.4% for submucous resections [4]. In particular, in the same manner in both groups have high perforation rates appears to be associated with the surgical technique used rather than the pack or splint effect. Surgery and follow-up was done by the same surgeon and used Killian incision is stated in the article. In surgery, entering with Cottle’s hemitransfixion incision instead of Killian’s could both provides surgical field dominance and reduce dechirur rates. Dechirur is important factor
ACCEPTED MANUSCRIPT in the formation of perforation. Furthermore, removed cartilage and bone tissues placed again after crushed suitable are effective in preventing the perforation during septoplasty.
T
In our clinic, pack-free and trans-septal suturing technique is routinely applied and
RI P
recommended in septoplasty. Generally this technique does not cause any problem, if the patients are followed well. In our practice, we did not encounter perforation as we replaced
SC
and did not damage the tissues [5]. It should not been forgotten that pack free technique is the
MA NU
most comfortable for the patients.
*No
AC
CE
PT
ED
References [1] Shinkwin CA, Beasley N, Simo R, Rushton L, Jones NS.Evaluation of Surgicel Nu-knit, Merocel and Vasolene gauze nasal packs: a randomized trial. Rhinology 1996;34(11):41-43. [2] Dubin MR, Pletcher SD. Postoperative packing after septoplasty: is it necessary? Otolaryngol Clin North Am. 2009;42(2):279-285. [3]Deniz M, Ciftci Z, Isık A, Demirel OB, Gultekin E. The impact of different nasal packings on postoperative complications. Am J Otolaryngol 2014:35;554-557. [4] Tzadik A, Gilbert SE, Sade J. Complications of submucous resections of the nasal septum. Arch Otorhinolaryngol 1988:245(2);74-76. [5] Eski E, Adadan I, Hızal E, Yılmaz I. Effect of nasal pack use on surgical success in septoplasty. The Turkish journal of ear nose throat 2014;24(4):206-210
sponsorships or competing interests have been disclosed for this article.