Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
Am J Rhinol Allergy. 2011 May-Jun;25(3):182-5. doi: 10.2500/ajra.2011.25.3584.
Silastic splints have been used as effective tools for septal support, avoiding adhesion, and mucosal healing after septal surgery. Furthermore, although many surgeons insert septal splints, no well-designed trials exist to support their use. A randomized double-blinded controlled trial was performed.
We recruited 40 subjects who had undergone septoplasty only without sinus surgery or turbinoplasty. A silastic septal splint was inserted in one side of the nasal cavity at the end of each septoplasty, with the other side serving as a control. The splint side and control side were randomly selected. Nasal discomfort score (10-point scale) and mucosal status (grades 1-4) were surveyed in a blinded setting on postoperative days 7 and 14.
Forty of 83 subjects fulfilled the enrollment criteria. On the 7th postoperative day there was no significant difference in nasal discomfort between the splint and control sides (6.2 ± 1.28 and 5.7 ± 1.27, respectively; p = 0.116), but the mucosal status was better on the splint side than on the control side (1.5 ± 0.51 and 2.5 ± 0.85; p < 0.001). At 14 days postoperatively, the symptom score (2.7 ± 1.06 versus 3.8 ± 1.25; p < 0.001) and mucosal status (1.5 ± 0.55 versus 1.9 ± 0.68; p = 0.013) were significantly better on the splint side compared with the control side.
Insertion of a silastic septal splint after septal surgery should be accepted as a routine procedure.
硅橡胶夹板已被用作鼻中隔支撑、避免粘连和鼻中隔手术后黏膜愈合的有效工具。此外,尽管许多外科医生会插入鼻中隔夹板,但没有设计良好的试验来支持其使用。本研究进行了一项随机双盲对照试验。
我们招募了 40 名仅接受鼻中隔成形术而未接受鼻窦手术或鼻甲切除术的患者。在每例鼻中隔成形术结束时,将硅橡胶鼻中隔夹板插入鼻腔的一侧,另一侧作为对照。夹板侧和对照侧随机选择。在盲法环境下,于术后第 7 天和第 14 天调查鼻腔不适评分(10 分制)和黏膜状况(1-4 级)。
83 例患者中有 40 例符合入组标准。术后第 7 天,夹板侧和对照侧的鼻腔不适程度无显著差异(分别为 6.2 ± 1.28 和 5.7 ± 1.27;p = 0.116),但夹板侧的黏膜状况优于对照侧(分别为 1.5 ± 0.51 和 2.5 ± 0.85;p < 0.001)。术后 14 天,症状评分(2.7 ± 1.06 与 3.8 ± 1.25;p < 0.001)和黏膜状况(1.5 ± 0.55 与 1.9 ± 0.68;p = 0.013)在夹板侧均显著优于对照侧。
鼻中隔手术后插入硅橡胶鼻中隔夹板应被视为常规操作。