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Kim SJ, Chang DS, Choi MS, Lee HY, Pyo JS. Efficacy of nasal septal splints for preventing complications after septoplasty: A meta-analysis. Am J Otolaryngol 2021; 42:102389. [PMID: 33482562 DOI: 10.1016/j.amjoto.2020.102389] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 12/19/2019] [Accepted: 01/03/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND The efficacy of nasal septal splints, which are used as alternatives to nasal packs for preventing complications such as synechia and maintaining septal stability after septoplasty, remains controversial. The present meta-analysis assessed the efficacy and safety of nasal septal splints used after septoplasty. METHODS PubMed and Google Scholar databases were systematically searched until June 20, 2019. Randomized controlled trials or cohort or case-control studies comparing patients who received nasal septal splints with those who did not receive splints after septoplasty were included. Primary outcomes included postoperative pain, infection, bleeding, hematoma formation, synechia, and perforation. Random effects models were used to calculate risk differences and risk ratios with 95% confidence intervals (CIs). RESULTS Thirty-three eligible studies were included. The estimated rate of synechia was significantly lower in the splint group (0.037, 95% CI 0.024-0.056) than in the no splint group (0.087, 95% CI 0.055-0.135; P = 0.003), while visual analog scale scores for pain and the estimated rates of infection, bleeding, hematoma, and perforation were comparable between groups. CONCLUSIONS These findings suggest that the use of nasal septal splints as alternatives or in addition to nasal packing prevent synechia after septoplasty without increasing other complications, including pain, thus adding to evidence supporting the use of septal splints, particularly in cases where postoperative synechia is expected.
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Zarrati S, Fathesami S, Manafi A. Custom nasal stent and columellar reconstruction after a rhinoplasty complication: A clinical report. J Prosthet Dent 2021; 128:823-826. [PMID: 33691937 DOI: 10.1016/j.prosdent.2020.12.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 11/20/2022]
Abstract
Nostril stenosis is typically caused by retraction and contraction after trauma or infection, although loss of nasal tissue is not common during rhinoplasty. This clinical report describes the fabrication of a nasal stent to replace the lost columella and a columella prosthesis for a patient who had had reconstructive surgery for nasal valve collapse and a missing columella. The stent established a comfortable means of nasal air exchange that was also esthetically acceptable. The stent also provided the necessary support for the nasal tissue before further nasal reconstructive surgeries.
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Affiliation(s)
- Simindokht Zarrati
- Assistant professor, Maxillofacial Prosthodontist, Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | | | - Ali Manafi
- Associate Professor of Plastic Surgery, Iran University of Medical Science, Tehran, Iran
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3
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Dal SB. Doyle silicone splint insertion: endoscopy-assisted versus nasal speculum assisted. Braz J Otorhinolaryngol 2020; 87:578-582. [PMID: 32888892 PMCID: PMC9422461 DOI: 10.1016/j.bjorl.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/06/2020] [Accepted: 07/15/2020] [Indexed: 11/26/2022] Open
Abstract
Introduction Septoplasty and endoscopic sinus surgery are very often concurrently performed operations in otolaryngology practice. The most common complication of endoscopic sinus surgery is lateralization of the middle turbinate. In our practice intranasal stenting is done routinely with Doyle silicone splints. Objective Retrospectively, we aimed to review the postoperative period and to document efficacy of endoscopy-assisted Doyle silicone splint application on prevention of middle turbinate lateralization. Methods Patients who had failed medical therapy and who underwent elective primary endoscopic sinus surgery for chronic rhinosinusitis with septal deviation requiring septoplasty were included to the study. Doyle silicone splints were inserted to all patients at the end of the operation with nasal speculum or with endoscopic assistance. Groups were compared for position of the middle turbinate at the end of the postoperative first month regarding lateralization and for pain score recorded on the second postoperative day. Results In the Doyle silicone splints applied with nasal speculum group, there were 46 patients with a total of 80 operated sides. In the endoscopy assisted group, there were 54 patients with a total of 88 operated sides. At the 1 month follow-up, the mean of middle turbinate position scores was 1.62 in the speculum-assisted group and 1.80 in the endoscopy-assisted group, the difference between two groups was found to be statistically significant. Mean of postoperative second day pain scores were worse in patients with the Doyle silicone splints applied with endoscopic assistance. This difference was found statistically significant. Conclusion In our study, after concomitant endoscopic sinus surgery and septoplasty, less middle turbinate lateralization was observed when the Doyle silicone splints were inserted with endoscopic guidance. The surgical techniques or methods of sinus packing as well as nasal packing may have an impact on middle turbinate lateralization after concurrent septoplasty and endoscopic sinus surgery.
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Affiliation(s)
- Secil Bahar Dal
- VKV Amerikan Hastanesi, Otolaryngology Department, Istanbul, Turkey.
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Koçak İ, Şentürk E. A new modification of Doyle splint (Hemi-split Doyle) in rhinoplasty with alar base reduction. Eur Arch Otorhinolaryngol 2017; 274:3667-3672. [PMID: 28795232 DOI: 10.1007/s00405-017-4701-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 08/03/2017] [Indexed: 11/26/2022]
Abstract
Patients perceive the pulling of a nasal splints as the most feared and stressful part of nasal surgery. Even the incisions made for alar base surgery can partly or entirely dehisce. So, we have been using modified Doyle silicone splints. We compared the modified Doyle silicone splints with conventional Doyle silicone splint. Included in the study were 64 patients undergoing alar base surgery together with open septorhinoplasty. Group 1 (n = 32) patients received a conventional Doyle intranasal silicone splint and group 2 (n = 32) received modified splint that we call a hemi-split Doyle splint. The pain felt by the patients during the removal of the splints was recorded according to the visual analogue scale (VAS). On days two and four postoperatively, the nasal stuffiness score (NOSE) was recorded. On day four postoperatively an intranasal examination was conducted to establish if dehiscence had occurred on the alar base incision line. In group 2, the pain scores during splints removal were significantly lower than those in group 1. Whereas no dehiscence on the alar base incision line was observed after tampon removal in group 2, the incision dehisced in eight patients in group 1. The NOSE scores on postoperative days two and four showed no difference between the groups. The hemi-split Doyle splint causes less pain during removal and particularly does not lead to dehiscence of incisions made during alar base surgery in rhinoplasty patients.
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Affiliation(s)
- İlker Koçak
- Department of Otolaryngology, Koç University Hospital, Davutpasa Cad. No: 4, Topkapi, 34010, Istanbul, Turkey.
| | - E Şentürk
- Department of Otorhinolaryngology, Alaca State Hospital, Alaca, Corum, Turkey
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5
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Ginat DT. Posttreatment Imaging of the Paranasal Sinuses Following Endoscopic Sinus Surgery. Neuroimaging Clin N Am 2015; 25:653-65. [PMID: 26476384 DOI: 10.1016/j.nic.2015.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Endoscopic sinus surgery is a minimally invasive option for the treatment of several nonneoplastic indications, particularly for medically refractory sinusitis and polyposis. Numerous interventions can be performed through endoscopic sinus surgery, many of which may be performed together during the same procedure. There are also a variety of complications that can result from endoscopic sinus surgery. Radiological imaging plays an important role in the evaluation of patients after endoscopic sinus surgery. Thus, it is important to be familiar with the expected and complicated imaging findings associated with endoscopic sinus surgery, which are reviewed in this article.
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Affiliation(s)
- Daniel Thomas Ginat
- Department of Radiology, University of Chicago Medical Center, Pritzker Medical School, 5841 South Maryland Avenue, Chicago, IL 60637, USA.
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Shadfar S, Deal AM, Jarchow AM, Yang H, Shockley WW. Practice patterns in the perioperative treatment of patients undergoing septorhinoplasty: a survey of facial plastic surgeons. JAMA FACIAL PLAST SU 2014; 16:113-9. [PMID: 24311187 DOI: 10.1001/jamafacial.2013.2050] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
IMPORTANCE The common practices used in the perioperative care of patients undergoing septorhinoplasty are diverse and controversial. A consensus statement on the preferred clinical pathway in the perioperative treatment of patients undergoing septorhinoplasty has yet to be approached formally. OBJECTIVES To investigate the perioperative treatment of patients undergoing septorhinoplasty and to identify common practice patterns based on the preferences of leading facial plastic surgeons. DESIGN, SETTING, AND PARTICIPANTS We distributed an online survey to members of the American Academy of Facial Plastic and Reconstructive Surgery. Specifically, fellowship directors and academic contact members were anonymously polled and stratified by the number of septorhinoplasties performed annually. MAIN OUTCOME AND MEASURE A cohesive clinical guide to perioperative treatment after rhinoplasty. RESULTS Of the 92 members surveyed, 67 (73%) successfully completed the survey. The distribution of respondents included 43 academicians (64%) and 24 physicians in private practice (36%). Twenty-eight surgeons (42%) performed fewer than 50 rhinoplasties a year and 39 (58%), more than 50, representing 3510 to 4549 septorhinoplasties in total among respondents. Forty-four surgeons (66%) refrained from using any packing, and 41 (61%) used intranasal splints, with polymeric silicone splints the most popular of these (n = 24 [59%]). Sixty-six surgeons (99%) used external nasal splints, including 49 (74%) who used a thermoplastic splint and 49 (74%) who left the external nasal splint in place for 7 days or longer. The most common postoperative interventions to reduce edema and ecchymosis were elevation of the head of bed by 62 (93%), ice packs by 50 (75%), and Arnica montana by 33 (49%). Only 12 surgeons (18%) used postoperative corticosteroids to reduce edema. Fifty-six respondents (84%) prohibited participation in contact sports until at least 6 weeks after surgery. CONCLUSIONS AND RELEVANCE Perioperative care and practices after nasal surgery vary among the most highly trained and leading rhinoplasty surgeons. No published communication or consensus on perioperative practices has been disseminated in this setting. Given the results from those surgeons performing the most rhinoplasties in our field, some surgeons may choose to vary their practices to coincide with those of experienced surgeons. These guidelines could facilitate future studies of patient outcomes.
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Affiliation(s)
- Scott Shadfar
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center Biostatistics Core, University of North Carolina, Chapel Hill
| | - Andrea M Jarchow
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill
| | - Hojin Yang
- Lineberger Comprehensive Cancer Center Biostatistics Core, University of North Carolina, Chapel Hill
| | - William W Shockley
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of North Carolina, Chapel Hill
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Deniz M, Ciftçi Z, Işık A, Demirel OB, Gültekin E. The impact of different nasal packings on postoperative complications. Am J Otolaryngol 2014; 35:554-7. [PMID: 24943408 DOI: 10.1016/j.amjoto.2014.04.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 04/22/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to find out if there is any association between the use of nasal packings and nasal synechia formation, septal perforation, postoperative infection and epistaxis in patients who underwent septoplasty and concha reduction operations. METHODS This retrospective study was conducted at a tertiary referral center. One hundred thirty patients were randomly selected among patients who underwent endonasal surgery in Namık Kemal University Hospital between January 1st 2012 and August 1st 2013. Retrospective analysis of these patients' files, including operative reports and follow-up notes, was done. The postoperative findings of patients who had septal splints and Merocel nasal packings were compared and analyzed for statistical significance. RESULTS The results of the study showed a statistically significant difference in the frequency of synechia formation between two groups (p<0.05). The frequency of synechia formation was found to be higher in the Merocel packing group. However, no statistically significant difference was found between groups in terms of postoperative infection, septal perforation, and epistaxis (p>0.05). CONCLUSION Our findings suggest that intranasal splints are superior to Merocel nasal packings in terms of preventing nasal synechia formation. Insertion of a septal splint after nasal surgery should be preferred to avoid this complication. On the other hand, other factors should be sought in the etiology of postoperative infection, septal perforation, and epistaxis.
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Affiliation(s)
- Mahmut Deniz
- Namık Kemal University, Medical Faculty, Department of Otorhinolaryngology, Tekirdağ, Turkey.
| | - Zafer Ciftçi
- Namık Kemal University, Medical Faculty, Department of Otorhinolaryngology, Tekirdağ, Turkey.
| | - Aklime Işık
- Namık Kemal University, Medical Faculty, Department of Otorhinolaryngology, Tekirdağ, Turkey.
| | - Oral Burak Demirel
- Namık Kemal University, Medical Faculty, Department of Otorhinolaryngology, Tekirdağ, Turkey.
| | - Erdoğan Gültekin
- Namık Kemal University, Medical Faculty, Department of Otorhinolaryngology, Tekirdağ, Turkey.
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Antohi N, Ionescu R, Antohi A, Isac C. Modified nasal vestibule packing with airway preservation. Aesthet Surg J 2014; 34:472-4. [PMID: 24676417 DOI: 10.1177/1090820x14524770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Nicolae Antohi
- Dr N. Antohi is an Associate Clinical Professor and Dr Isac is an Assistant Professor in the Plastic and Reconstructive Surgery Department, University of Medicine and Pharmacy "Carol Davila," Hospital of Plastic, Reconstructive and Burns Surgery, Bucharest, Romania
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Quinn JG, Bonaparte JP, Kilty SJ. Postoperative management in the prevention of complications after septoplasty: a systematic review. Laryngoscope 2013; 123:1328-33. [PMID: 23625653 DOI: 10.1002/lary.23848] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Revised: 09/17/2012] [Accepted: 10/04/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS The purpose of this article is to assess the relative rates of septal hematomas, synechiae, and septal perforations associated with methods commonly used to manage the nasal septum after septoplasty. As a secondary objective, we assessed the relative contribution of each method of septal management with respect to pain and patient discomfort. STUDY DESIGN Systematic review. METHODS A systematic literature search was performed for all relevant English randomized controlled, cohort, or case-control trials. Inclusion criteria included any study that assessed postoperative septal hematoma, perforation, or synechiae formation and reported on these outcomes regardless of method of septoplasty. Two authors independently extracted study information and analyzed all included articles for bias. RESULTS A total of 279 studies were identified, with 17 meeting the inclusion criteria. The majority of the studies had a high risk of bias that prevented the performance of a meta-analysis. Eight studies provided data on postoperative pain associated with different techniques, and quilting sutures were found to be significantly less painful than both nasal packing and septal splints. CONCLUSIONS Due to the low level of evidence and the high bias of the studies, the results of this systematic review fail to demonstrate a clear benefit among any of the postseptoplasty treatment techniques. However, the results do demonstrate that septal sutures are associated with less postoperative pain versus the other methods of septal management in this review.
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Banglawala SM, Gill M, Sommer DD, Psaltis A, Schlosser R, Gupta M. Is nasal packing necessary after septoplasty? A meta-analysis. Int Forum Allergy Rhinol 2012; 3:418-24. [PMID: 23136013 DOI: 10.1002/alr.21110] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 07/26/2012] [Accepted: 08/28/2012] [Indexed: 11/07/2022]
Abstract
BACKGROUND Nasal packing is routinely used after septoplasty because it is believed to decrease risk of postoperative bleeding, hematomas, and adhesions. Multiple studies have shown, however, that there are numerous complications associated with nasal packing. The purpose of this work was to perform a meta-analysis on the existing literature to evaluate the role of nasal packing after septoplasty. METHODS Two independent reviewers conducted a literature search using EMBASE, OVID, Medline, PubMed, Google scholar, Cochrane Library, and reference list review from 1966 to August 2010 to identify studies assessing nasal packing after septoplasty. All papers were reviewed for study design, results, and were assigned an Oxford level of evidence grade, Detsky score, and Methodological Index for Nonrandomized Studies (MINORS) score. RESULTS Sixteen papers were identified that met the inclusion criteria. Eleven papers were randomized control trials, 3 were prospective, and 2 were retrospective studies. Nasal packing did not show benefit in reducing postoperative bleeding, hematomas, septal perforations, adhesions, or residual deviated nasal septum. There was, however, an increase in postoperative infections. Two studies using fibrin products as nasal packing showed a decreased bleeding rate. CONCLUSION Nasal packing after septoplasty does not show any postoperative benefits. Fibrin products show a possibility of decreasing postoperative bleeding. Routine use of nasal packing after septoplasty is not warranted. This is the first meta-analysis conducted on this topic.
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Affiliation(s)
- Sarfaraz M Banglawala
- Otolaryngology-Head and Neck Surgery, McMaster University, Hamilton, Ontario, Canada.
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Abstract
LEARNING OBJECTIVES After studying this article, the participant should be able to: 1. Identify potential hemorrhagic, infectious, traumatic, functional, or aesthetic complications arising from rhinoplasty. 2. Gain a better understanding of the prevention of these complications. 3. Have a thorough knowledge of the principles of postoperative management of these complications, so as to minimize their deleterious effects and preserve aesthetic outcomes in rhinoplasty. SUMMARY Meticulous attention to detail in the operating room and in the postoperative period is paramount to achieving success in rhinoplasty. Nevertheless, both complications and suboptimal results do occur, even for experienced surgeons.
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Becker DG, Ransom E, Guy C, Bloom J. Surgical treatment of nasal obstruction in rhinoplasty. Aesthet Surg J 2010; 30:347-78; quiz 379-80. [PMID: 20601558 DOI: 10.1177/1090820x10373357] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Often, rhinoplasty patients present not just for aesthetic correction, but for improvement of their nasal breathing due to functional abnormalities or problems. Because the aesthetic and functional problems must be addressed together, an understanding of both the internal and external anatomy is essential. In this article, the authors review the differential diagnosis of nasal obstruction and the important components of a thorough examination. In this article, medical treatment options are not discussed, but just as an exacting aesthetic analysis leads to an appropriate cosmetic rhinoplasty plan, a thorough functional analysis will dictate the appropriate medical or surgical treatment.
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Bloom JD, Kaplan SE, Bleier BS, Goldstein SA. Septoplasty complications: avoidance and management. Otolaryngol Clin North Am 2009; 42:463-81. [PMID: 19486742 DOI: 10.1016/j.otc.2009.04.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Nasal obstruction from a deviated septum is one of the more frequent complaints bringing patients into an otolaryngology office. Despite the significant number of septoplasties performed each year, complications after this procedure are relatively uncommon. Most complications result from inadequate surgical planning or poor technique and often can be prevented. Surgeons should discuss these risks with patients before surgery as part of the informed consent process. This article reviews how complications of septoplasty can occur, compromising the functional and aesthetic aspects of a patient's life, and how attention to detail can reduce the risk for these complications. The septoplasty surgeon must be aware of all the possible complications that may arise so as to convey the benefits and risks of surgery effectively to prospective patients.
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Affiliation(s)
- Jason D Bloom
- Department of Otolaryngology-Head and Neck Surgery, University of Pennsylvania, 811 Spruce Street, Philadelphia, PA 19107, USA
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The atraumatic septorhinoplasty. EUROPEAN JOURNAL OF PLASTIC SURGERY 2005. [DOI: 10.1007/s00238-005-0788-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
OBJECTIVES/HYPOTHESIS The study aimed to detect the changes in adult rabbit nasal septal tissues after application of nasal pack or trans-septal suture as performed during septoplasty. STUDY DESIGN Randomized double-blind animal study. METHODS Thirty-three adult albino Vienna rabbits were assigned into the following groups: control, suture, and nasal pack. The mucoperichondrium at one side of the nasal septum was elevated and then put into place again over the cartilage and fixed with either a nasal pack or an absorbable trans-septal suture. The nasal packs were removed 48 hours after insertion. Rabbits were killed 6 weeks after the procedure. The nasal septa were stained with hematoxylin and eosin and examined by means of light microscopy for mucosal changes (inflammation or damage) and for thicknesses of the mucosa, the perichondrium, and the cartilage. RESULTS Both intranasal packs and sutures caused significant mucosal inflammation and damage when compared with the control group (chi test, P <.05). The mucosal thickness did not change, but the perichondrial thickness for both the nasal pack group and the suture group increased (Mann-Whitney U test, P <.05). Also, the septal cartilage thickness was not significantly different between the suture and the nasal pack groups, but the suture group had a thinner septal cartilage than the control group (Mann-Whitney U test, P <.05). CONCLUSION The septal suture is an efficient and useful method for clinching the septal flaps over the septal cartilage. In addition, it has nearly the same effects as nasal packs on the histological appearance of the nasal septum and does not cause discomfort for the patient. The septal suture can be a preferred alternative to intranasal packing.
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Affiliation(s)
- Erkhan Genç
- Department of Otorhinolaryngology and Pathology, Başkent University, Ankara, Turkey.
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Mantovani M, Guastella C, Mazzola RF. The Guastella-Mantovani septal-valve splint: an intranasal biplanar and multivectorial orthopedic device. Plast Reconstr Surg 2000; 106:475-8. [PMID: 10946948 DOI: 10.1097/00006534-200008000-00039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A new internal nasal device, the Guastella-Mantovani septal-valve splint, ensures the correct healing of the crucial area of the internal valve, simultaneously "centering" the septum orthopedically after nasal surgery.
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Affiliation(s)
- M Mantovani
- Department of Otorhinolaryngology, Ospedale Maggiore IRCCS, University of Milan, Italy
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