Li Hui, Wang Min, Wu Yu-Xiao, Wang Szuchi, Xing Zhi-Min
Department of Otorhinolaryngology Head and Neck Surgery, The People's Hospital of Peking University, Xi Zhi Men Nan Da Jie 11#, Beijing, 100044, China.
World J Otorhinolaryngol Head Neck Surg. 2017 Mar 17;3(1):44-48. doi: 10.1016/j.wjorl.2017.02.002. eCollection 2017 Mar.
Nasal packing is routinely applied after septoplasty. Patients, however, report feeling very uncomfortable while the packing is in place. The aim of this study was to compare the effects of nasal septum suture combined with inferior turbinate coblation to the effects of nasal packing after septoplasty.
In this study, 135 patients undergoing septoplasty were divided into 3 groups: group 1 patients had microdebrider with packing, group 2 received coblation with packing and group 3 had coblation with suture. Early postoperative quality of life and complications were compared between the 3 groups.
The patients in group 1 experienced the most postoperative nasal pain, headache, dysphagia, sleep disturbance and bleeding on the night of surgery; while the patients in group 3 experienced the fewest symptoms. No difference in epiphora was observed between the 3 groups. More pain and bleeding were experienced when comparing the pack removal (Group 1 and 2) with the clearance of the nasal cavity (Group 3). We noted one case of postoperative bleeding in group 1, one septal hematoma in group 1 and a second septal hematoma in group 2. No such postoperative complications were found in group 3.
Nasal septum suture combined with inferior turbinate coblation was not only associated with less pain, increased patient satisfaction and an improved quality of life; but also reduced postoperative complications. Our results confirm that it is a more comfortable, reliable alternative to the more common nasal packing.
鼻中隔成形术后通常会进行鼻腔填塞。然而,患者表示填塞物在位时感觉非常不适。本研究的目的是比较鼻中隔缝合联合下鼻甲消融术与鼻中隔成形术后鼻腔填塞的效果。
在本研究中,135例行鼻中隔成形术的患者被分为3组:第1组患者采用微型切割器并进行填塞,第2组接受消融术并进行填塞,第3组接受消融术并进行缝合。比较3组患者术后早期的生活质量和并发症情况。
第1组患者术后出现的鼻部疼痛、头痛、吞咽困难、睡眠障碍和手术当晚出血最为严重;而第3组患者出现的症状最少。3组患者在溢泪方面未观察到差异。与鼻腔清理组(第3组)相比,取出填塞物组(第1组和第2组)出现的疼痛和出血更多。我们注意到第1组有1例术后出血,第1组有1例鼻中隔血肿,第2组有1例鼻中隔血肿。第3组未发现此类术后并发症。
鼻中隔缝合联合下鼻甲消融术不仅疼痛更少、患者满意度提高且生活质量改善;还减少了术后并发症。我们的结果证实,与更常见的鼻腔填塞相比,它是一种更舒适、可靠的替代方法。