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Is nasal packing necessary following endoscopic sinus surgery?
Richard R Orlandi1, Donald C Lanza
1Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA. richard.orlandi@hsc.utah.edu
The Laryngoscope
|October 12, 2004
Summary
Nasal packing or hemostatic agents are generally not necessary after endoscopic sinus surgery. Avoiding these interventions can prevent associated risks, costs, and discomfort for patients undergoing the procedure.
Area of Science:
- Otolaryngology
- Rhinology
- Surgical Innovation
Background:
- Endoscopic sinus surgery (ESS) is a common procedure.
- The routine use of nasal packing or hemostatic agents post-ESS is debated.
- Potential complications and patient discomfort associated with packing exist.
Purpose of the Study:
- To evaluate the necessity of nasal packing or hemostatic agents after ESS.
- To assess the impact of these materials on postoperative bleeding complications.
Main Methods:
- Retrospective chart review of 165 patients (169 surgeries) at a tertiary care sinus practice.
- Data collected included adjunctive procedures, use of packing/hemostatic agents, blood loss, and bleeding complications.
- Analysis of trends in the use of packing or hemostatic agents over time.
Main Results:
- Median blood loss during surgery was 50 mL.
- Only 13.6% of surgeries utilized packing or hemostatic agents; 87.0% had no material left in the nose.
- No postoperative bleeding complications were observed in any patients.
- A significant decrease in the use of packing or hemostatic agents was noted over time.
Conclusions:
- Nasal packing or hemostatic agents are not required in most endoscopic sinus surgeries.
- Eliminating these interventions can avoid associated risks, costs, and patient discomfort.
- This supports a more conservative approach in postoperative care following ESS.