International Journal of Medical and All Body Health Research  |  e-ISSN: 2582-8940  |  Double-Blind Peer Review  |  Open Access  |  CC BY-NC-SA 4.0

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     2026:7/4

International Journal of Medical and All Body Health Research

e-ISSN: 2582-8940 | Open Access

Postoperative Outcome of Transseptal Suturing and Merocele Nasal Packing During Septoplasty among Cases with Symptomatic Deviated Nasal Septum

Article Information

Volume / Issue5 / 4 (December-December 2024)
Pages118-124
AccessOpen Access

Publication Timeline

  • Received25 October 2024
  • Accepted29 November 2024

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Abstract

Introduction: Nasal obstruction is one of the most common complaints in cases attending otorhinolaryngology surgeon’s practice. One of the causes for nasal obstruction is deviated nasal septum. Deviation of the nasal septum is a common structural cause of nasal obstruction and can arise from dislocation of the quadrangular cartilage from its bony boundaries. Septoplasty is a surgical procedure that corrects a deformity of the nasal septum.

Aim: To assess and compare the postoperative outcome of transseptal suturing versus merocele nasal packing during septoplasty regarding the postoperative pain, bleeding and synechiae.

Material and methods: This is a prospective, comparative study done in the Department of ORL-HNS, Bir Hospital, Kathmandu with the patients undergoing septoplasty. A total of 70 patients with an age range of 15-65 years were included irrespective of gender diagnosed as symptomatic DNS (Deviated Nasal Septum) who underwent septoplasty. The patients were divided into two groups Group A and Group B during registration in outpatients department. Group A patients underwent septoplasty with transseptal suturing without merocele nasal packing whereas Group B patients underwent septoplasty with merocele nasal packing without transseptal suturing. Postoperative pain and bleeding were assessed on 6th hour, 12th hour, 1st ,2nd, 3rd, 7th and after 42nd POD (postoperative day). Presence of synechiae was assessed on 7th POD and 42nd POD.

Results: The mean age was 28.31 +/- 9.149 years. Patients who underwent septoplasty with transeptal suturing reported lower pain scores compared to their counterparts and the differences were statistically significant at 6th hour, 12th hour, 1st POD, 3rd POD and 7th POD with p-value 0.0001, 0.0001, 0.0001, 0.29 and 0.0001 respectively. Synechiae was observed in patients who underwent septoplasty with merocele nasal packing on 7th POD. The p-value for synechiae on 7th POD was 0.028. No synechiae was observed on 42nd POD. Bleeding was only the complication that was commonly associated with septoplasty with transseptal suturing as compared to septoplasty with merocele nasal packing which was statistically significant (p=0.42).

Conclusion: There were increased potential morbidity (pain and synechiae) in cases of septoplasty with merocele nasal packing without transseptal suturing in comparison to septoplasty with transseptal suturing without merocele nasal packing. So, septoplasty with transseptal suturing can be good alternative to septoplasty with packing.

References

  1. Cummings Otolaryngology: Head and Neck Surgery. In: 6th ed. Philadelphia: Elsevier; 2015:476. [Google Scholar][Crossref]
  2. Gleeson M. Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery. 7th ed. Chapter 167. p. 2193-2210. [Google Scholar][Crossref]
  3. Konstantinidis I, Triaridis S, Triaridis A, Karagiannidis K, Kontzoglou G. Long-term results following nasal septal surgery: focus on patients’ satisfaction. Auris Nasus Larynx. 2005;32(4):369-74. [Google Scholar][Crossref]
  4. Fettman N, Sanford T, Sindwani R. Surgical management of the deviated septum: techniques in septoplasty. Otolaryngologic Clinics of North America. 2009;42(2):241-52. [Google Scholar][Crossref]
  5. Harugop AS, Mudhol RS, Hajare PS, Nargund AI, Metgudmath VV, Chakrabarti S. Prevalence of nasal septal deviation in newborns and its precipitating factors: a cross-sectional study. Indian Journal of Otolaryngology and Head and Neck Surgery. International Journal of Medical and All Body Health Research www.allmedicaljournal.com 2012;64(3):248-51. [Google Scholar][Crossref]
  6. Samad I, Stevens HE, Maloney A. The efficacy of nasal septal surgery. Journal of Otolaryngology. 1992;21(2):88-91. [Google Scholar][Crossref]
  7. Aziz T, Biron VL, Ansari K, Flores-Mir C. Measurement tools for the diagnosis of nasal septal deviation: a systematic review. Journal of Otolaryngology - Head and Neck Surgery. 2014;43(1):11. [Google Scholar][Crossref]
  8. Rao JJ, Kumar ECV, Babu KR, Chowdary VS, Singh J, Rangamani SV. Classification of nasal septal deviations: relation to sinonasal pathology. Indian Journal of Otolaryngology and Head and Neck Surgery. 2005;57(3):199-201. [Google Scholar][Crossref]
  9. Stewart MG, Smith TL, Weaver EM, Witsell DL, Yueh B, Hannley MT, et al. Outcomes after nasal septoplasty: results from the Nasal Obstruction Septoplasty Effectiveness (NOSE) study. Otolaryngology - Head and Neck Surgery. 2004;130(3):283-90. [Google Scholar][Crossref]
  10. Kulkarni SV, Kulkarni VP, Burse K, Bharath M, Bharadwaj C, Sancheti V. Endoscopic septoplasty: a retrospective analysis of 415 cases. Indian Journal of Otolaryngology and Head and Neck Surgery. 2015;67(3):248-54. [Google Scholar][Crossref]
  11. Dąbrowska-Bień J, Skarżyński PH, Gwizdalska I, Łazęcka K, Skarżyński H. Complications in septoplasty based on a large group of 5639 patients. European Archives of Oto -Rhino-Laryngology. 2018;275(7):1789-94. [Google Scholar][Crossref]
  12. Wang WW, Dong BC. Comparison on effectiveness of trans-septal suturing versus nasal packing after septoplasty: a systematic review and meta-analysis. European Archives of Oto -Rhino-Laryngology. 2017;274(11):3915-25. [Google Scholar][Crossref]
  13. Wang J, Cai C, Wang S. Merocel versus Nasopore for nasal packing: a meta-analysis of randomized controlled trials. PLoS ONE [Internet]. 2014 Apr 7 [cited 2021 Mar 29];9(4). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC39779 61/. [Google Scholar][Crossref]
  14. Cukurova I, Cetinkaya EA, Mercan GC, Demirhan E, Gumussoy M. Retrospective analysis of 697 septoplasty surgery cases: packing versus trans-septal suturing method. Acta Otorhinolaryngologica Italica. 2012;32(2):111-4. [Google Scholar][Crossref]
  15. Dubin MR, Pletcher SD. Postoperative packing after septoplasty: is it necessary? Otolaryngologic Clinics of North America. 2009;42(2):279-85. [Google Scholar][Crossref]
  16. Kuboki A, Kikuchi S, Asaka D, Onda N, Nakayama T, Kojima H, et al. Nasal silicone splints and quilting sutures using a septum stitch device following septoplasty: a prospective comparative study. European Archives of Oto -Rhino-Laryngology. 2018;275(7):1803-9. [Google Scholar][Crossref]
  17. Mladina R, Skitarelić N, Poje G, Šubarić M. Clinical implications of nasal septal deformities. Balkan Medical Journal. 2015;32(2):137-46. [Google Scholar][Crossref]
  18. Dadgarnia M, Meybodian M, Karbasi A, Baradaranfar M, Atighechi S, Zand V, et al. Comparing nasal packing with trans-septal suturing following septoplasty: a randomized clinical trial. European Archives of Oto-Rhino-Laryngology. 2017;274(9):3513-8. [Google Scholar][Crossref]
  19. Ghimire A, Limbu T, Bhandari R. Trans-septal suturing following septoplasty: an alternative for nasal packing. Journal of Nepal Medical Association. 2018;56(4):307-11. [Google Scholar][Crossref]
  20. Said SM. Comparison of the effect of trans-septal suture technique versus intranasal Merocel packing regarding local nasal pain and sleep disturbances after septoplasty. Egyptian Journal of Otolaryngology. 2019;35(2):123-7. [Google Scholar][Crossref]
  21. Walikar BN, Rashinkar SM, Watwe MV, Fathima A, Kakkeri A. A comparative study of septoplasty with or without nasal packing. Indian Journal of Otolaryngology and Head and Neck Surgery. 2011;63(3):247-8. [Google Scholar][Crossref]
  22. Alroqi A, Alhumaizi A, Alsukayt M, Almutairi A. Figure-of-eight suturing in endoscopic septoplasty: a convenient technique in wound closure. Journal of Otorhinolaryngology. 2017;5(2):3. [Google Scholar][Crossref]
  23. Eski E, Yılmaz I. Effect of nasal packs in septoplasty. American Journal of Otolaryngology; 2015:36. [Google Scholar][Crossref]
  24. Nayak DR, Balakrishnan R, Murthy KD. An endoscopic approach to the deviated nasal septum-a preliminary study. Journal of Laryngology and Otology. 1998;112(10):934-9. [Google Scholar][Crossref]
  25. Moorthy P, Kolloju S, Madhira S, Jowkar A. Clinical study on deviated nasal septum and its associated pathology. International Journal of Otolaryngology and Head and Neck Surgery. 2014;3(1):75-81. [Google Scholar][Crossref]
  26. Ocalan R, Akin C, Disli ZK, Kilinc T, Ozlugedik S. Preoperative anxiety and postoperative pain in patients undergoing septoplasty. B-ENT. 2015;11(1):19-23. [Google Scholar][Crossref]
  27. Ku D, Vasan K, Wong E, Tseros E, Singh NP. Moffett’s solution causes significantly greater postoperative throat pain compared to Cophenylcaine in sinonasal surgery. International Journal of Otolaryngology. 2019;2019:e3738647. [Google Scholar][Crossref]
  28. (Unavailable). Please provide the title and authors for this reference. [Google Scholar][Crossref]
  29. (Unavailable). Please provide the title and authors for this reference. [Google Scholar][Crossref]
  30. Naghibzadeh B, Peyvandi A, Naghibzadeh G. Does post-septoplasty nasal packing reduce complications? Acta Medica Iranica. 2011;49(1):9-12. [Google Scholar][Crossref]
  31. Awan MS, Iqbal M. Nasal packing after septoplasty: a randomized comparison of packing versus no packing in 88 patients. Ear, Nose, & Throat Journal. 2008;87(11):624-7. [Google Scholar][Crossref]
  32. Plasencia DP, Falcón JC, Barreiro SB, Bocanegra-Pérez MS, Barrero MV, Macías ÁR. Transeptal suturing: a cost-efficient alternative for nasal packing in septal surgery. Brazilian Journal of Otorhinolaryngology. 2016;82(3):310-3. [Google Scholar][Crossref]
  33. (Unavailable). Please provide the title and authors for this reference. [Google Scholar][Crossref]
  34. Baptistella E, Rispoli D, Malucelli D, Trotta F, Costa A, Rispoli L, et al. Degree of the patient’s satisfaction and postoperative complications for septoplasty surgery with and without the use of nasal buffer. International Archives of Otorhinolaryngology; 2008:12. [Google Scholar][Crossref]
  35. Alshawadfy M, Fouad Y, Ahmed M, Fouad A, Alshawadfy M. With or without postoperative nasal packing: a comparative study. Zagazig University Medical Journal; 2017:23. [Google Scholar][Crossref]
  36. Ardehali MM, Bastaninejad S. Use of nasal packs and intranasal septal splints following septoplasty. International Journal of Oral and Maxillofacial Surgery. 2009;38(10):1022-4. International Journal of Medical and All Body Health Research www.allmedicaljournal.com Copyright and License © The Author(s). Authors retain the copyright of their published articles. This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution Non Commercial-Share A like 4.0 International (CC BY-NC-SA 4.0) License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. [Google Scholar][Crossref]

How to Cite

Bishankha, D., Gautam, D., Panta, T., Gurung, L. B., Thapa, N., GC, A., Mulmi, R. G., & Kayastha, S. (2024). Postoperative Outcome of Transseptal Suturing and Merocele Nasal Packing During Septoplasty among Cases with Symptomatic Deviated Nasal Septum. International Journal of Medical and All Body Health Research, 5(4), 118-124. https://doi.org/10.54660/IJMBHR.2024.5.4.118-124

Bishankha, Dhiraj, et al. "Postoperative Outcome of Transseptal Suturing and Merocele Nasal Packing During Septoplasty among Cases with Symptomatic Deviated Nasal Septum." International Journal of Medical and All Body Health Research, vol. 5, no. 4, 2024, pp. 118-124. https://doi.org/10.54660/IJMBHR.2024.5.4.118-124.

Bishankha, D., Gautam, D., Panta, T., Gurung, L. B., Thapa, N., GC, A., Mulmi, R. G. and Kayastha, S. (2024) 'Postoperative Outcome of Transseptal Suturing and Merocele Nasal Packing During Septoplasty among Cases with Symptomatic Deviated Nasal Septum', International Journal of Medical and All Body Health Research, 5(4), pp. 118-124. doi: 10.54660/IJMBHR.2024.5.4.118-124.

Bishankha D, Gautam D, Panta T, Gurung LB, Thapa N, GC A, et al. Postoperative Outcome of Transseptal Suturing and Merocele Nasal Packing During Septoplasty among Cases with Symptomatic Deviated Nasal Septum. International Journal of Medical and All Body Health Research. 2024;5(4):118-124. doi:10.54660/IJMBHR.2024.5.4.118-124

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