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.