Comparison of the effect of conventional nasal packing and merocel packing following deviated septal surgeries

Abstract

Context: Nasal packs are necessary after nasal surgery for hemostasis and internal stabilization of bony and cartilaginous structures. Aims: The study was done to compare the outcomes of conventional nasal packing and Merocel packing in terms of the middle ear pressure, mucociliary clearance, patient comfort, and complication. Settings and Design: A prospective study was conducted among 40 patients in a tertiary care center for 18 months. Subjects and Methods: The patients between 18 and 50 years and who underwent septal surgery were included in the study. The patients with any history of ciliary dysfunction, who underwent functional endoscopic sinus surgery with septoplasty, and any middle ear diseases were excluded from the study. The patients were divided into Group 1, which had conventional nasal pack and Group 2, which had Merocel postoperatively. All the patients were assessed with impedance audiometry and sacchrin test preoperatively and postoperatively at 1, 2 and 4 weeks and these were compared between the 2 groups. During pack removal, pain and bleeding and postoperative complications were also compared between the groups. Statistical Analysis Used: The difference between the two-group comparison student t-tests, the differences between the right and left sides of the same tests paired t-test. The association/difference between categorical variables Chi-square test was calculated at a 5% level of significance. Results: Group 1 and Group 2 had a mean age of 38.47 and 37.47, respectively. Gender predisposition in Group 2 is 1:1 and in Group 1 is 3:2. The middle ear pressure returns to normal by 2nd week in Group 2 compared to Group 1, which improved by 4th week (P < 0.05). The mucociliary clearance reverts to normal by 1st week in Group 2 and 4th week in Group 1 (P = 0.0001) was statistically significant. Group 2 had lesser pain scores assessed using visual analog scores (P = 0.0001) and less bleeding (P = 0.01), which was statistically significant. Group 2 has fewer postoperative complications. Conclusions: The conventional and Merocel packs were both effective packs. In terms of mucociliary clearance, the middle ear pressure Merocel packing was better, and conventional nasal packing had more incidence in terms of postoperative complications.