Wang Min, Xing Zhimin, Yuan Xiaopei, Liu Yan, Han Lin, Qin Nan
Department of Otolaryngology, People's Hospital, Peking University, Beijing, 100044, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2011 Dec;25(23):1068-70, 1075.
Patients undergone septoplasty, which is one of the most common procedures, always feel very painful after surgery because of routine nasal packing. The objective of this study was to evaluate the effect of septal suture technique without nasal packing after septoplasty.
Eighty patients who had undergone septoplasty were included in this study. The patients were allocated into tow groups: packing group, mercel was used for nasal packing after septoplasty and inferior turbinate coblation; suturing group, septal suture and inferior turbinate coblation were performed after septoplasty without nasal packing. Postoperative signs and symptoms(visual analogue scale,VAS) were compared between the two groups.
The patients of packing group experienced significantly more postoperative nasal pain, headache, dysphagia, sleep disturbance and bleeding after surgery (P < 0.01). No difference of epiphora was found between the two groups. More pain and bleeding were experienced during the pack removal(packing group), compared to that during the clearance of nasal cavity (suturing group ). One patient with postoperative septal hematoma was found in the packing group.
Nasal septum suture combined with inferior turbinate coblation might be a significantly more comfortable, reliable alternative to nasal packing. Nasal packing is not the necessary application for septoplasty.
鼻中隔成形术是最常见的手术之一，由于常规鼻腔填塞，患者术后常感到非常疼痛。本研究的目的是评估鼻中隔成形术后不进行鼻腔填塞的鼻中隔缝合技术的效果。
本研究纳入80例行鼻中隔成形术的患者。患者被分为两组：填塞组，鼻中隔成形术和下鼻甲消融术后使用纱条进行鼻腔填塞；缝合组，鼻中隔成形术后不进行鼻腔填塞，仅行鼻中隔缝合和下鼻甲消融。比较两组术后的体征和症状（视觉模拟评分法，VAS）。
填塞组患者术后鼻痛、头痛、吞咽困难、睡眠障碍及出血明显更多（P<0.01）。两组间溢泪情况无差异。与鼻腔清理时（缝合组）相比，取出填塞物时（填塞组）疼痛和出血更多。填塞组发现1例术后鼻中隔血肿患者。
鼻中隔缝合联合下鼻甲消融可能是比鼻腔填塞明显更舒适、可靠的替代方法。鼻腔填塞并非鼻中隔成形术的必要操作。
