Zubair Iqbal Bhutta, Ali Husnain Sheikh, Muhammad Dawood Saleem, Shuman Roy.
Comparison of the results of anterior nasal packing versus without anterior nasal packing for better management of septoplasty.
J Allama Iqbal Med Coll Jan ;19(4):998-1004.

Objective: The rationale of this study was to compare the results of anterior nasal packing versus without anterior nasal packing for better management of septoplasty. Methods: This study was conducted in the department of ENT, Akhtar Saeed Trust Hospital Lahore on 220 patients who were randomly divided in two equal groups. Septoplasty was performed by a single team of surgeons and patients were followed till 6 weeks for evaluation of post-septoplasty complications like pain, septal hematoma and bleeding. Data was collected on a specially designed proforma (attached) and analysed on SPSS version 20. Results: In this study of 220 patients, there were 139 males and 81 females with age range from 18 to 45 years. The mean age of 139 (63.2%) male patients and 81 (39.1%) female patients was 25.90 ± 5.974.The female to male ratio was 1:1.7. In group “A” consisting of 67 (60.9%) male and 43 (39.1%) female patients the mean age was 25.89 ± 5.97. Similarly, group “B” consisting of 72 (65.5%) male and 38 (34.5%) female patients the mean age was 25.92 ± 6.194. In group “A” (with anterior nasal packing) after septoplasty 51 (46.4%), 45 (40.9%) and 14 (12.1%) patients described mild, moderate and severe pain respectively on visual analog scale. In group “B” (without anterior nasal packing) 18 (16.4%) had no pain and 92 (83.6%) patients had mild pain during the first 24 hours post-operatively (P-value < 0.05). During septoplasty 03 (2.75) patients from each group developed primary heamorrhage of grade I. Reactionary haemorrhage was noted in 27 (24.5%) patient in group A and 8 (7.30%) in group B. Secondary heamorrhage was noted in 26 (23.6%) patients in group A and 04 (3.6%) in group B with statistically significant difference (P-value < 0.05). Conclusion: On the basis of results in two groups, post-septoplsty complications rate of pain, primary & secondary haemorrhage was less in group B (without anterior nasal packing) than in group A (with anterior nasal packing). Septal hematoma formation was rare in both groups and statistically was not significant. On the basis of result obtained from this study, it is recommended that septoplasty operation without anterior nasal packing can be used confidently to achieve best surgical results. Key words: Deviated nasal septum, anterior nasal packing, septal haematoma, visual analog scale

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