Karataş Duran, Yüksel Fatih, Doğan Murat, Sentürk Mehmet
From the Ear Nose Throat, Melikgazi Medical Center, Kayseri, Turkey.
J Craniofac Surg. 2014 Mar;25(2):602-3. doi: 10.1097/SCS.0000000000000685.
The aim of this study was to investigate the effects of transseptal suturing against 3 different types of nasal packings with respect to pain, operating time, and postoperative complications after nasal septal surgery.
Two hundred twenty-eight patients (aged between 18 and 58 y) undergoing nasal septal surgery were included in the study. After surgery, 4 types of nasal packing were used: (1) transseptal suturing (group A: 57 patients), (2) internal nasal splint (group B: 57 patients), (3) Merocel standard 8-cm packing without airway (group C: 57 patients), and (4) soft paraffin gauze dressing (group D: 57 patients).
Regarding the mean operating time, there was no statistically significant difference among groups B, C, and D (P > 0.05). However, when the operating times observed in the said 3 groups were compared with those observed in group A, the difference was statistically significant (P < 0.05). The mean (SD) postoperative pain score within 1 to 48 hours was 2.9 (1.3; median, 2) in group A, 6.3 (1.4; median, 6) in group B, 7.5 (1.1; median, 7) in group C, and 7.7 (1.8; median, 7) in group D. Starting from the postoperative 48th hour, internal nasal splint, Merocel packing, and soft paraffin gauze dressing were significantly more painful compared with transseptal suturing (P < 0.05). When compared with the other groups, extubation period and postoperative care unit stay were shorter in the transseptal suturing group (P < 0.05). Regarding infection, hematoma, synechia, or perforation, there was no statistically significant difference among the groups (P > 0.05).
Transseptal suturing technique is a useful alternative to packing, with only a minor increase in operating time. Particularly, transseptal suturing shortens extubation time and postoperative care unit stay.
本研究旨在探讨鼻中隔缝合术与3种不同类型鼻腔填塞物相比，在鼻中隔手术后对疼痛、手术时间及术后并发症的影响。
本研究纳入228例接受鼻中隔手术的患者（年龄在18至58岁之间）。术后使用4种鼻腔填塞物：（1）鼻中隔缝合术（A组：57例患者），（2）鼻内夹板（B组：57例患者），（3）无气道的Merocel标准8厘米填塞物（C组：57例患者），以及（4）软石蜡纱布敷料（D组：57例患者）。
关于平均手术时间，B组、C组和D组之间无统计学显著差异（P>0.05）。然而，将上述3组观察到的手术时间与A组观察到的手术时间进行比较时，差异具有统计学显著性（P<0.05）。术后1至48小时的平均（标准差）疼痛评分在A组为2.9（1.3；中位数，2），B组为6.3（1.4；中位数，6），C组为7.5（1.1；中位数，7），D组为7.7（1.8；中位数，7）。从术后第48小时开始，鼻内夹板、Merocel填塞物和软石蜡纱布敷料与鼻中隔缝合术相比疼痛明显更严重（P<0.05）。与其他组相比，鼻中隔缝合术组的拔管期和术后监护病房停留时间更短（P<0.05）。关于感染、血肿、粘连或穿孔，各组之间无统计学显著差异（P>0.05）。
鼻中隔缝合术是一种有用的填塞替代方法，仅使手术时间略有增加。特别是，鼻中隔缝合术缩短了拔管时间和术后监护病房停留时间。
