Cayonu Melih, Acar Aydın, Horasanlı Eyup, Altundag Aytug, Salihoglu Murat
Department of Otolaryngology and Head Neck Surgery, Amasya University Training and Research Hospital , Amasya.
Acta Otolaryngol. 2014 Apr;134(4):390-4. doi: 10.3109/00016489.2013.878476. Epub 2014 Feb 11.
The patients who underwent septoplasty with bilateral totally occlusive nasal packing had an increased risk of experiencing respiratory distress (RD).
To compare the immediate RD rates during recovery from anesthesia and surgical complications of totally occlusive nasal pack, internal nasal splint, and transseptal suture technique.
A total of 150 patients were assigned to one of three groups according to the technique utilized following septoplasty: transseptal suturing, internal nasal splint, or Merocel (nasal dressing without airway). To determine RD related to anesthesia in the operating theatre, the criterion was defined as any unanticipated hypoxemia, hypoventilation or upper airway obstruction (stridor or laryngospasm) requiring an active and specific intervention. Postoperative hemorrhage, infection, synechia formation, and septal perforation were evaluated.
Patients in the Merocel group were 3.6 times more likely to have RD than patients in the transseptal suture and internal nasal splint groups. Also, patients who smoked had an increased risk of RD during the recovery phase of anesthesia after the septoplasty. In addition, all three techniques resulted in similar complication rates after septoplasty, with the exception of minor hemorrhage, which had a significantly higher rate in the transseptal suture group.
接受鼻中隔成形术并双侧完全闭塞性鼻腔填塞的患者发生呼吸窘迫（RD）的风险增加。
比较完全闭塞性鼻腔填塞、鼻内夹板和鼻中隔缝合技术在麻醉恢复期间的即时RD发生率及手术并发症。
根据鼻中隔成形术后采用的技术，将150例患者分为三组之一：鼻中隔缝合、鼻内夹板或Merocel（无气道的鼻腔敷料）。为确定手术室中与麻醉相关的RD，标准定义为任何需要积极且特定干预的意外低氧血症、通气不足或上呼吸道梗阻（喘鸣或喉痉挛）。评估术后出血、感染、粘连形成和鼻中隔穿孔情况。
Merocel组患者发生RD的可能性是鼻中隔缝合组和鼻内夹板组患者的3.6倍。此外，吸烟患者在鼻中隔成形术后麻醉恢复阶段发生RD的风险增加。另外，除少量出血外，三种技术在鼻中隔成形术后的并发症发生率相似，鼻中隔缝合组的少量出血发生率明显更高。
