Feasibility Studies ; Humans ; Nose ; Rhinoplasty ; methods ; Tampons, Surgical

OBJECTIVE: To assess the efficacy and adverse reaction of nasal packing materials Rapid Rhino and Merocel. METHOD: We searched the database PubMed, EMBASE, Cochrane Library, CBM, CNKI, VIP and WANFANG database on line by computer, and traced the related references. Randomized controlled trials(RCTs) of rapid rhino and merocel as nasal packing materials were included. The quality of the included documents was evaluated by the criterion of Cochrane handbook 5.1. The cochrane collaboration's Revman 5.1 software was used for data analysis. RESULT: Four RCTs involving 115 patients were identified. Meta-analyses showed that Rapid Rhino produced significantly lower pain and discomfort during insert of pack [MD = 1.37, 95% CI (0.13, 2.60), P < 0.05], whereas less pain and discomfort during removal of pack [MD = 2.88, 95% CI (2.34, 3.41), P < 0.01]. Rapid Rhino associated with a significantly slighter degree of fullness raised after insertion [MD = 1.15, 95% CI (0.75, 1.55), P < 0.01, and the same situation happened after 6 hours [MD = 1.15, 95% CI (0.75, 1.55), P < 0.01]. Rapid rhino caused to less reactionary bleeding when pack removal [MD = 0.26, 95% CI (0.12, 0.39), P < 0.01], rapid rhino was easier for the healthcare worker during insert and removal. There was no significant difference between two packs on the efficiency of hemostatic [OR = 1.00, 95% CI (0.38, 2.61), P > 0.05]. CONCLUSION The application of Rapid Rhino caused less pain and fullness, leaded to slighter bleed than Merocel when insertion and removal. There was no significant difference between two packs on the efficiency of hemostatic when used for epistaxis or after routine nasal surgery.
Bandages ; Epistaxis ; surgery ; Formaldehyde ; therapeutic use ; Humans ; Polyvinyl Alcohol ; therapeutic use ; Randomized Controlled Trials as Topic ; Tampons, Surgical ; Treatment Outcome

Packing the nose after septoplasty is common practice. The use of postoperative packing has been proposed to reduce the dead space between the subperichondrial flaps and minimize postoperative complications such as hemorrhage, septal hematoma, and formation of synechiae. Additionally, postoperative packing is thought to stabilize the remaining cartilaginous septum and minimize persistence or recurrence of septal deviation. Despite these theoretic advantages, evidence to support the use of postoperative packing is lacking. Additionally, nasal packing is not an innocuous procedure. The use of nasal packing actually cause these complications such as postop- erative pain, mucosal injury, bleeding, worsening of breathing due to sleep disorders, and postoperative infections. Routine use of anterior nasal packing after septoplasty should be challenged for not presenting proven benefit. As alternatives to traditional packing, septal suturing, septal stapler and fibrin glue have been used recently. The purpose of this article is to summarize the progress of traditional packing to no packing after septoplasty.
Bandages ; Epistaxis ; Humans ; Nasal Cartilages ; surgery ; Nasal Septum ; abnormalities ; surgery ; Pain, Postoperative ; Postoperative Complications ; Postoperative Period ; Rhinoplasty ; methods ; Surgical Flaps ; Sutures ; Tampons, Surgical ; statistics & numerical data

OBJECTIVE: To study whether negative-pressure septal drainage could be an alternative to packs after septoplasty. METHOD: This was a randomized controlled trial. The study involved 60 patients who underwent septoplasty. Patients were randomly divided into two groups, one with anterior nasal packs and the other with negative-pressure septal drainage. Patients were asked to record pain levels using a visual analogue scale (VAS). Postoperative symptoms and complications were compared during 24 h and 48 h postoperative period including pain, drying sensation of mouth, sleep difficulty, conjunctival congestion, haemorrhage. VAS scores and incidence were evaluated during 1 week and 6 weeks postoperative period including pain, bleeding, haematoma, septal perforation, synechiae and septal perforation. RESULT: Patients of negative-pressure septal drainage suffered from less pain than patients of nasal packs during the first 24 h and 48 h postoperative period. The results for pain, drying sensation of mouth, sleep difficulty, conjunctival congestion, haemorrhage were different between groups (P < 0.05), especially the amount of bleeding during 48 h postoperatively in patients undergoing negative pressure drainage [(0.52 ± 0.63)ml] was significantly less than the group who received anterior nasal packs [(21.03 ± 5.88) ml] (P < 0.01). On the other hand, haematoma, synechiae and perforation were not statistically different between groups during 1 week and 6 weeks follow-up period (P > 0.05). CONCLUSION Using negative-pressure drainage instead of nasal packs after septoplasty seems a more reasonable option. The negative-pressure drainage technique may be the preferred option to provide higher patient satisfaction and has the same level of postoperative complica.tion to nasal packs as for septoplasty surgery.
Drainage ; Humans ; Nasal Septum ; surgery ; Nasal Surgical Procedures ; Negative-Pressure Wound Therapy ; methods ; Nose ; Pain Measurement ; Patient Satisfaction ; Postoperative Period ; Tampons, Surgical

OBJECTIVE: To study the safety and feasibility after functional Endoscopic surgery(FESS), without no nasal packing in 74 patients,compare these patients with 20 packing patients, and discuss the possibility and indication of avoiding packing. METHOD: No nasal packing after FESS in 74 patients, the measures had been taken to reduce postoperative bleeding including appropriate case-chosen, medical administration before and after operation, alleviation of trauma in operation, and meticulous sinus clearance to prevent synechia. RESULT: The postoperative blood loss were less than 50 ml. No bleeding complication happened out of the 74 no-packing patients, the blood exudation ceased timely after FESS. CONCLUSION The nasal packing could be avoided in the majority of FESS through proper management. This choice will reduce the discomfort and the cost of the patients who have to receive FESS procedure, and increase their compliance.
Adolescent ; Adult ; Chronic Disease ; Endoscopy ; methods ; Feasibility Studies ; Female ; Hemostatic Techniques ; Humans ; Male ; Middle Aged ; Otorhinolaryngologic Surgical Procedures ; methods ; Postoperative Hemorrhage ; prevention & control ; Postoperative Period ; Sinusitis ; surgery ; Tampons, Surgical ; Treatment Outcome ; Young Adult