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What Is the Ideal Packing and Ointment after Nasal Surgery?

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Challenges in Rhinology

Abstract

Nasal packing is an essential component of ENT surgery. Following many different surgical procedures on the nose, e.g. rhinoplasty, septoplasty, turbinate minimization or cautery, nasal packing plays a key role in preventing haemorrhage or crust formation and, on occasion, helps secure flaps or grafts in the correct alignment. The range of products composed of various materials and marketed for use as packing has been steadily growing. Nasal packing materials need to (1) promote haemostasis following nosebleeds or an operation; (2) offer structural support to cartilage or bone, the conchae or other soft tissues (such as to an advancement flap); and (3) stop adhesions forming or stenosis developing, particularly after sinus procedures. This kind of pack needs to remain in place for a more extensive period. Struts and some materials offer particular benefit in these uses. In this chapter, ideal packing and ointment after nasal surgery are presented.

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References

  1. Weber RK. Nasal packing and stenting. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2009;8:Doc02. https://doi.org/10.3205/cto000054. Epub 2011 Mar 10

    Article  PubMed  Google Scholar 

  2. Weber R, Keerl R. Einsatz moderner Bild-Datenverarbeitung in der klinisch rhinologischen Forschung. Eur Arch Otorhinolaryngol. 1996;Suppl I:271–96.

    Google Scholar 

  3. Weber R, Hosemann W, Draf W, Keerl R, Schick B, Schinzel S. Endonasale Stirnhöhlenchirurgie mit Langzeiteinlage eines Platzhalters. Laryngo-Rhino-Otologie. 1997;76:728–34. https://doi.org/10.1055/s-2007-997515.

    Article  CAS  PubMed  Google Scholar 

  4. Weber R, Mai R, Hosemann W, Draf W, Toffel PH. The success of 6-month stenting in endonasal frontal sinus surgery. ENT J. 2000;79:930–41.

    CAS  Google Scholar 

  5. Weitzel EK, Wormald PJ. A scientific review of middle meatal packing/stents. Am J Rhinol. 2008;22:302–7. https://doi.org/10.2500/ajr.2008.22.3171.

    Article  PubMed  Google Scholar 

  6. Weber R, Hochapfel F, Leuwer R, Freigang B, Draf W. Tamponaden und Platzhalter in der endonasalen Chirurgie. HNO. 2000;48:240–56.

    Article  CAS  Google Scholar 

  7. Beule AG, Weber RK, Kaftan H, Hosemann W. Übersicht: Art und Wirkung geläufiger Nasentamponaden. Laryngo-Rhino-Otologie. 2004;83:534–51. https://doi.org/10.1055/s-2004-825695.

    Article  CAS  PubMed  Google Scholar 

  8. Bresnihan M, Mehigan A, Curran A. An evaluation of Merocel and Series 5000 nasal packs in patients following nasal surgery: a prospective randomised trial. Clin Otolaryngol. 2007;32:352–5.

    Article  CAS  Google Scholar 

  9. Badran K, Malik TH, Belloso A, Timms MS. Randomized controlled trial comparing Merocel and rapid rhino packing in the management of anterior epistaxis. Clin Otolaryngol. 2005;30:333–7.

    Article  CAS  Google Scholar 

  10. Singer AJ, Blanda M, Cronin K, LoGiudice-Khwaja M, Gulla J, Bradshaw J, Katz A. Comparison of nasal tampons for the treatment of epistaxis in the emergency department: a randomized controlled trial. Ann Emerg Med. 2005;45:134–9.

    Article  Google Scholar 

  11. Cruise AD, Amonoo-Kuofi K, Srouji I, Kanagalingam J, Georgalas C, Patel NN, Baida L, Lund VJ. A randomized trial of rapid rhino Riemann and telfa nasal packs following endoscopic sinus surgery. Clin Otolaryngol. 2006;31:25–32.

    Article  CAS  Google Scholar 

  12. Gudziol V, Mewes T, Mann WJ. Rapid Rhino: a new pneumatic nasal tamponade for posterior epistaxis. Otolaryngol Head Neck Surg. 2005;132:152–5.

    Article  CAS  Google Scholar 

  13. McGarry GW, Aitken D. Intranasal balloon catheters: how do they work? Clin Otolaryngol Allied Sci. 1991;16:388–92.

    Article  CAS  Google Scholar 

  14. Simmen DB, Raghavan U, Briner HR, Manestar M, Groscurth P, Jones NS. The anatomy of the sphenopalatine artery for the endoscopic sinus surgeon. Am J Rhinol. 2006;20:502–5.

    Article  Google Scholar 

  15. Gehrking E, Weerda H. A modified nasal tamponade with foam rubber protection in epistaxis. Laryngo-Rhino-Otologie. 1995;74:463–4.

    Article  CAS  Google Scholar 

  16. Ho EC, Mansell NJ. How we do it: a practical approach to Foley catheter posterior nasal packing. Clin Otolaryngol Allied Sci. 2004;29:754–7.

    Article  CAS  Google Scholar 

  17. Catalano PJ, Roffman EJ. Evaluation of middle meatal stenting after minimally invasive sinus techniques (MIST). Otolaryngol Head Neck Surg. 2003;128:875–81.

    Article  Google Scholar 

  18. Rust KR, Stringer SP, Spector B. The effect of absorbable stenting on postoperative stenosis of the surgically enlarged maxillary sinus ostia in a rabbit animal model. Arch Otolaryngol Head Neck Surg. 1996;122:1395–7.

    Article  CAS  Google Scholar 

  19. Tom LW, Palasti S, Potsic WP, Handler SD, Wetmore RF. The effects of gelatin film stents in the middle meatus. Am J Rhinol. 1997;11:229–32.

    Article  CAS  Google Scholar 

  20. Baumann A, Caversaccio M. Hemostasis in endoscopic sinus surgery using a specific gelatin-thrombin based agent (FloSeal). Rhinology. 2003;41:244–9.

    PubMed  Google Scholar 

  21. Björses K, Holst J. Various local hemostatic agents with different modes of action; an in vivo comparative randomized vascular surgical experimental study. Eur J Vasc Endovasc Surg. 2007;33:363–70.

    Article  Google Scholar 

  22. Chandra RK, Conley DB, Kern RC. The effect of FloSeal on mucosal healing after endoscopic sinus surgery: a comparison with thrombin-soaked gelatin foam. Am J Rhinol. 2003;17:51–5.

    Article  Google Scholar 

  23. Chandra RK, Conley DB, Haines GK 3rd, Kern RC. Long-term effects of FloSeal packing after endoscopic sinus surgery. Am J Rhinol. 2005;19:240–3.

    Article  Google Scholar 

  24. Shrime MG, Tabaee A, Hsu AK, Rickert S, Close LG. Synechia formation after endoscopic sinus surgery and middle turbinate medialization with and without FloSeal. Am J Rhinol. 2007;21:174–9.

    Article  Google Scholar 

  25. Maccabee MS, Trune DR, Hwang PH. Effects of topically applied biomaterials on paranasal sinus mucosal healing. Am J Rhinol. 2003;17:203–7.

    Article  Google Scholar 

  26. Antisdel JL, Janney CG, Long JP, Sindwani R. Hemostatic agent microporous polysaccharide hemospheres (MPH) does not affect healing or intact sinus mucosa. Laryngoscope. 2008;118:1265–9.

    Article  CAS  Google Scholar 

  27. Vaiman M, Eviatar E, Shlamkovich N, Segal S. Use of fibrin glue as a hemostatic in endoscopic sinus surgery. Ann Otol Rhinol Laryngol. 2005;114:237–41.

    Article  Google Scholar 

  28. Gameiro Dos Santos J, Figueirinhas R, Liberal JP, et al. On ciprofloxacin concentration in chronic rhinosinusitis. Acta Otorrinolaringol Esp. 2018;69(1):35–41. https://doi.org/10.1016/j.otorri.2017.06.008. Epub 2017 Aug 30

    Article  PubMed  Google Scholar 

  29. Ketoprofen topical. European Medicines Agency. https://www.ema.europa.eu/en/medicines/human/referrals/ketoprofen-topical. Accessed 20 Jan 2020.

  30. Erickson CH, McLeod RL, Mingo GG, Egan RW, Pedersen OF, Hey JA. Comparative oral and topical decongestant effects of phenylpropanolamine and d-pseudoephedrine. Am J Rhinol. 2001;15(2):83–90.

    Article  CAS  Google Scholar 

  31. Laccourreye O, Werner A, Giroud JP, et al. Benefits, limits and danger of ephedrine and pseudoephedrine as nasal decongestants. Eur Ann Otorhinolaryngol Head Neck Dis. 2015;132(1):31–4.

    Article  CAS  Google Scholar 

  32. Lanolin Pharmaceutical Grade. https://www.fr-lanolin.com/product/products _description/Lanolin_Pharmaceutical_Grade.html. Accessed 20 Jan 2020.

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Resuli, A.S., Cingi, C., Lee, J.T. (2021). What Is the Ideal Packing and Ointment after Nasal Surgery?. In: Cingi, C., Bayar Muluk, N., Scadding, G.K., Mladina, R. (eds) Challenges in Rhinology. Springer, Cham. https://doi.org/10.1007/978-3-030-50899-9_29

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  • DOI: https://doi.org/10.1007/978-3-030-50899-9_29

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-50898-2

  • Online ISBN: 978-3-030-50899-9

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