Nasal septal clips: an alternative to nasal packing after septal surgery?

Surgeons have debated since decades on the efficacy or inefficacy of nasal packing yet it is considered routine after septal surgery. Various types of septal splints have been tried as an alternative to nasal packs but most of them need to be sutured around the septum which requires a meticulous approach and expertise. Our aim is to assess and compare the immediate post-operative morbidity and the eventual outcome of septal surgery while using glove finger packs with that of septal clips with splints. This comparative study was done at MCV Memorial ENT Trust Hospital on 80 patients who were diagnosed to have DNS and underwent septal surgery. Patients were divided into two groups. Group A (n = 40) constituted of patients who had glove finger packs and Group B (n = 40) constituted of patients who had septal clips. In the immediate post-operative period patients were assessed for pain, headache, dysphagia, epiphora, dryness of mouth and post-operative bleed. On the first post-operative night, patients were assessed for oxygen saturation. Patients underwent tympanometry just before pack/splint removal and on reviews if the same was abnormal. Post-operative complications like septal perforation and synechiae were noted for both groups and compared. We found that the incidence of pain and various other signs and symptoms was significantly higher in Group A. The difference in the complication rates among the two groups was not statistically significant. We observed that nasal packing is a cause for significant morbidity and discomfort in the immediate post-operative period and does not give any added advantage over septal clips used in our study as far as the final outcome is concerned. Nasal septal clips with splints are a useful alternative to existing techniques of flap approximation after septal surgery. The method is not expensive and needs no special expertise.