Nasal Packing
Conditions
Brief summary
This study aims to to compare postoperative pain, patient comfort, and hemostatic safety among four non-absorbable nasal packing techniques following microdebrider-assisted inferior turbinoplasty (MAIT) and to identify the most effective low-cost packing option.
Interventions
Standard bilateral Merocel® nasal tampons (Medtronic, USA) were inserted in their dry compressed form. Prior to insertion, each tampon was trimmed according to the dimensions of the patient's nasal cavity. Following contact with nasal secretions, the Merocel expanded to provide gentle and uniform pressure over the operative site.
A Merocel® tampon was enclosed within the finger portion of a sterile powder-free latex surgical glove. The glove finger was then partially stripped to expose portions of the Merocel surface while retaining a thin latex interface, thereby preventing the glove from acting as a complete barrier and allowing contact between the Merocel and surrounding nasal secretions. This modification preserved the expansion and absorptive properties of the Merocel while creating a smoother, less adherent outer surface.
Merocel® tampons were coated with a thin uniform layer of topical broad-spectrum antibiotic ointment, such as fusidic acid 2% plus corticosteroids, prior to bilateral insertion. This modification was intended to provide localized antimicrobial coverage while preserving the hemostatic effect of the packing material.
Sterile ribbon gauze impregnated with white petroleum jelly (paraffin) was loosely packed into each nasal cavity in a layered accordion-like fashion, beginning at the nasal floor and progressing posteriorly. Packing density was standardized to achieve adequate hemostasis while avoiding excessive pressure on the nasal mucosa.
Sponsors
Study design
Eligibility
Inclusion criteria
* Adults aged 18-65 years. * Chronic bilateral nasal obstruction secondary to inferior turbinate hypertrophy. * Failure of conservative medical management for at least 3 months, including intranasal corticosteroids and oral antihistamines. * Positive decongestion test showing ≥30% improvement in anterior nasal cavity volume (V2-5 cm) on acoustic rhinometry after topical xylometazoline 0.5%, confirming predominantly mucosal rather than bony hypertrophy. * Inferior turbinate hypertrophy grade 3 or 4 according to the Camacho classification system.
Exclusion criteria
* Significant nasal septal deviation affecting the nasal valve region. * Internal or external nasal valve collapse or stenosis. * Chronic rhinosinusitis with or without nasal polyposis. * Previous nasal or paranasal sinus surgery. * Coagulopathy or current anticoagulant therapy. * Uncontrolled systemic disease. * Pregnancy. * Active smoking. * Known allergic sensitization to any component of the nasal packing materials.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain intensity | We assesed pain during first 48 hours postoperative. | 1.Pain intensity Assessed using the Visual Analogue Scale (VAS) (0 = no pain, 10 = worst imaginable pain) |
| Bleeding after packing removal Assessed using a 4-point grading scale | We assesed bleeding immediately after nasal packing removal | Grade 0 = no bleeding Grade 1 = oozing Grade 2 = continuous bleeding Grade 3 = bleeding requiring intervention or control in the operating room |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Nasal fullness/pressure sensation | We assesed it during first 48 hours postoperative. | Nasal fullness/pressure sensation Assessed using the Visual Analogue Scale (VAS; 0-10) |
Countries
Egypt