Cytological alterations of nasal mucosa after nasal packing

To assess the efficacy, tolerability and cytological alterations of nasal mucosa with various materials for nasal packing.

One hundred and five patients, submitted to a nasal surgery and post-operative packing with four different materials (Clauden®, Merocel®, two-fingered glove pack with gauzes inside and Lyofoam™) were prospectively enrolled in the study. All patients were submitted to a questionnaire of 12 questions which required the patients to refer to the tolerability of packing. Finally a nasal cytological test was performed after removal of packing and 10 days after, to evidence the alterations of ciliated cells and reduction of supranuclear stria.

The questionnaire of tolerability of packing revealed a severe discomfort (grade III) in 13 patients (38.2%) with Clauden, 1 (2.4%) with Merocel, 7 (41.1%) with two-fingered glove packing and 6 (46.1%) with Lyofon. As regards cellular alterations, the two-fingered glove and the Merocel groups had the lowest percentage of cellular alterations which was particularly different from the Clauden group (p=.0014) The supranuclear stria was reduced in the Clauden group and the two-fingered glove packing group both after packing removal and after ten days with a statistical difference when compared to the other two groups (p<.001).

Merocel packing appears to be well tolerated by the patients with the lowest percentage of cytological alteration, of ciliated cells. Also finger glove packing shows scarce damage of nasal mucosa with a lower percentage of nasal bleeding but its tolerability is not so good.