Do ventilated packs reduce post-operative eustachian tube dysfunction?

Area of Science:

• Otolaryngology
• Surgical Innovation
• Clinical Trials

Background:

• Nasal packing after surgery can cause Eustachian tube dysfunction.
• Cannulated nasal packs aim to improve nasopharyngeal ventilation.
• Eustachian tube dysfunction impacts middle ear pressure.

Purpose of the Study:

• To investigate if cannulated nasal packs reduce post-operative Eustachian tube dysfunction.
• To compare middle ear pressures with cannulated versus non-cannulated nasal packs.
• To assess the impact of nasopharyngeal ventilation on middle ear pressure after nasal surgery.

Main Methods:

• Prospective randomized controlled trial.
• Adult patients undergoing intranasal surgery without pre-operative Eustachian tube dysfunction.
• Randomization to cannulated or non-cannulated Merocel nasal packs.
• Measurement of middle ear pressures pre- and post-operatively.

Main Results:

• Both groups showed a significant post-operative change in middle ear pressure (P < 0.0001).
• No significant difference in post-operative middle ear pressure between cannulated (-85 dPa) and non-cannulated (-70 dPa) groups.
• Nasal surgery with packing objectively reduces middle ear pressure, irrespective of pack venting.

Conclusions:

• Venting nasal packs does not alter the objective reduction in middle ear pressure post-surgery.
• Cannulated nasal packs do not prevent post-operative Eustachian tube dysfunction compared to standard packing.
• Nasal surgery and packing significantly affect middle ear pressure, a finding not mitigated by cannulation.