Effect of nasal packing and haemostatic septal suture on mucociliary activity after septoplasty: an assessment by rhinoscintigraphy


KULA M. , YÜCE I. , ÜNLÜ Y. , TUTUŞ A. , ÇAĞLI S. , KETENCİ I.

EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY, vol.267, no.4, pp.541-546, 2010 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 267 Issue: 4
  • Publication Date: 2010
  • Doi Number: 10.1007/s00405-009-1119-0
  • Title of Journal : EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY
  • Page Numbers: pp.541-546
  • Keywords: Septal deviation, Nasal packing, Septal suturing, Mucociliary clearance, Rhinoscintigraphy, INFERIOR TURBINATE HYPERTROPHY, CLEARANCE FUNCTION, TRANSPORT, DEVIATION, PATTERNS, MUCOSA

Abstract

Nasal packing may influence the mucociliary clearance of the nose in the postoperative healing phase. In an attempt to overcome some of this problem, a haemostatic septal suturing technique was conceived. In this prospective study, we aimed to investigate the effects of nasal packing and septal suturing technique on mucociliary clearance by rhinoscintigraphy. Forty-eight adult patients who had undergone septoplasty were included in the investigation. Preoperatively, the patients were allocated into three groups: group 1, fingerstall packs filled with gauze and smeared with vaseline were used (11 male, 4 female); group 2, silicon septal splint packs were used (11 male, 4 female); group 3, haemostatic septal sutures were used (14 male, 4 female). Mucociliary clearance was measured by rhinoscintigraphy in all patients before surgery and 6 weeks after surgery. The nasal mucociliary clearance was presented as the velocity (mm/min) of nasal mucociliary transport of the (99m)Tc-MAA droplet. The mean velocity of nasal mucociliary clearances before and after surgery for group 1, group 2 and group 3 were 1.85 +/- A 0.67 versus 2.43 +/- A 0.78 mm/min, 2.36 +/- A 0.80 versus 2.92 +/- A 0.96 mm/min and 2.03 +/- A 0.58 versus 2.62 +/- A 0.65 mm/min, respectively. A significant difference in nasal mucociliary clearance was observed after surgery in all groups (p < 0.001). No significant differences were found between the groups regarding mucociliary clearance before and after surgery. Patients with septal deviation have a prolonged mucociliary transit time as compared with postoperative. Nasal packing did not significantly influence the mucociliary clearance in the postoperative healing phase.