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Alternatives to packing in septorhinoplasty
D Reiter1, E Alford, Z Jabourian
1Center for Facial Plastic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pa.
Archives of Otolaryngology--Head & Neck Surgery
|October 1, 1989
Summary
Nasal packing may not be necessary after nasal surgery. This study found that carefully performed surgery without packing resulted in minimal bleeding, suggesting packing can be avoided with refined surgical techniques.
Area of Science:
- Otolaryngology
- Rhinology
- Surgical Innovation
Background:
- Nasal packing is a common practice post-nasal and septal surgery.
- The evidence supporting the routine use of nasal packing is limited.
- Alternative approaches to hemostasis require investigation.
Purpose of the Study:
- To evaluate the efficacy of omitting nasal packing in nasal and septal surgeries.
- To identify key surgical techniques for achieving hemostasis without packing.
- To provide guidance for minimizing postoperative nasal bleeding.
Main Methods:
- A review of 75 consecutive nasal surgical procedures performed without nasal packing.
- Detailed documentation of surgical techniques and postoperative outcomes.
- Analysis of bleeding episodes and their management.
Main Results:
- Only two minor postoperative bleeding episodes occurred in 75 procedures.
- Bleeding originated from pyriform aperture incisions and was managed with absorbable gelatin sponge.
- No major complications or need for reoperation due to bleeding were reported.
Conclusions:
- Nasal packing can be safely omitted in select nasal and septal surgeries.
- Meticulous surgical technique, including specific refinements, is crucial for hemostasis.
- This approach minimizes patient discomfort and potential packing-related complications.