[Nasal packing after FESS--time is over?]

Area of Science:

• Otolaryngology
• Rhinology
• Surgical Innovation

Background:

• Growing trend to avoid nasal packing post-Functional Endoscopic Sinus Surgery (FESS).
• This shift is linked to advancements in atraumatic surgical techniques, including endoscopic approaches, minimal turbinate resection, and meticulous coagulation.
• A careful benefit-risk assessment is crucial to determine the necessity and type of nasal packing.

Purpose of the Study:

• To evaluate the role and alternatives to traditional nasal packing in endonasal surgery.
• To highlight methods that optimize wound healing and patient comfort while minimizing mucosal damage.

Main Methods:

• Review of current surgical practices and packing material properties.
• Analysis of hemostatic/resorbable materials and their associated complications.
• Evaluation of simple nasal external taping as a wound management strategy.

Main Results:

• Conventional packing, if used, should feature smooth surfaces to reduce mucosal damage and improve healing.
• Hemostatic/resorbable materials, while a step towards less invasive packing, can lead to increased synechiae and foreign body reactions.
• External nasal taping is identified as a simple, effective method for maintaining a moist nasal environment, aiding wound healing, and managing dry nose.

Conclusions:

• Nasal packing avoidance is favored in FESS due to surgical advancements.
• Careful selection of packing materials is essential when packing is necessary to minimize complications.
• External nasal taping presents a promising, low-risk alternative for optimizing endonasal wound healing and nasal dryness management.