Respiratory tubes with nasal packings following septorhinoplasty

The use of packings following septorhinoplasty is a matter of controversy. The recommendations go from gluing with fibrin glue only, if anything at all, over quilting stitches, perhaps in combination with silastic or teflon sheats or plates or these sheats alone, to the employment of various more substantial materials and in from 1 to even 14 days postoperatively. If long-term nasal packing is chosen following consideration of primary healing, patients will experience discomfort of mouth-breathing, but pressure in the ears, too. Therefore, our department has used respiratory tubes simultaneously with packings since 1971. In this study, 47 patients who underwent septo- and/or rhinoplasty were treated by nasal packings 6 days postoperatively. All patients were treated by silicone respiratory tubes, one group in all 6 days, one in 4 days only. Self-assessment as far as some typical complaints is concerned was carried out as well as tympanometry. There were statistically significant less complaints of pressure in the ears when tubes were used, and the period with tubes was significantly preferred to the period without. A low pressure in the middle ears was seen in many patients. The normalization was occurring significantly sooner with tubes. At the same time they seem to secure that the normalization will take place as fast as it has been demonstrated in an earlier study employing only 3 days of nasal packing. No synechias or perforations were seen at an early follow-up, 1-3 months postoperatively. When long-term packing is preferred, respiratory tubes then can be recommended as effective.