The effect of nasal packing and suture technique on systemic oxygen saturation and patient comfort after septoplasty

Abstract

OBJECTIVES: We investigated the effect of intranasal packing placed after septoplasty or alternatively suturing the septum without inserting a packing on systemic oxygen saturation and patient comfort. PATIENTS AND METHODS: The study involved 37 patients who underwent septoplasty for isolated septum deviation. Intranasal packing was used in 18 patients (5 women, 13 men; mean age 30+/-10 years; range 18 to 47 years), while 19 patients (5 women, 14 men; mean age 31+/-12 years; range 18 to 54 years) underwent nasal septal suturing. To evaluate systemic oxygen saturations, partial oxygen saturations were measured pre- and postoperatively by pulse oximetry. The effect of intranasal packing and suturing on patient comfort was assessed by a visual analog scale before and 48 hours after surgery, five days after removal of nasal packing, and 30 days after surgery. RESULTS: Postoperative systemic oxygen saturations exhibited higher levels in the sutured group, but this did not reach significance (p>0.05). The incidence of nasal obstruction was significantly higher with nasal packing (p<0.05). In general, headache and facial pain were more common with nasal packing, while suturing was associated with a higher frequency of nasal crusting, postnasal discharge, and reduced sense of smell (p>0.05). CONCLUSION: Considering that, albeit not significantly, intranasal packing used after septoplasty decreases systemic oxygen saturation more than suturing and thus, has more adverse effects on patient comfort, suturing the septum may be a better alternative, particularly in elderly patients with chronic systemic diseases.