Septoplasty without packing or splints: Our experience

Jafar Fawzi Al Badran, Otorhinolaryngology department, Basrah teaching hospital, Basrah, Iraq.Follow
Huda Hassan Al Abboodi, Planning department, Basrah dealth Directorate, Al- Zahraa college of medicine. University of Basrah, Basrah, Iraq.Follow

Article Type

Original Study

Abstract

Background: Septoplasty is a common surgical procedure performed in otorhinolaryngology departments to correct nasal septum deviation. Traditionally, nasal packing or splints used to stabilize the septal mucosal flaps and promote adhesion. However, these can cause complications such as nasal obstruction until removal, dry mouth, watering of eyes, severe pain during pack removal, headache, difficulty swallowing, and hypoxia. Methods: This prospective longitudinal observational study conducted on 50 patients undergoing septoplasty for nasal obstruction without the use of nasal packing or splints. This study included 50 patients who presented to the ENT department with nasal obstruction over one year (October 2021 to October 2022). The septal mucosa was sutured using 4-0 poly glycolic with an initial few quilting sutures, followed by continuous sutures to approximate the flaps and prevent septal hematoma. Patients monitored on the day of surgery and during follow-ups for bleeding or hematoma. The severity of nasal obstruction assessed using the NOSE score preoperatively, then reassessed at one week and one month postoperatively. Follow-up examinations evaluated the nasal cavities for synechiae, hematoma, septal perforation, or residual deviation. Results: Among the 50 patients, 36 were male and 14 were female. The youngest patient was 15 years old, and the oldest was 57 years old. Minor bleeding occurred in two patients within a few hours postoperatively in the recovery room. These patients treated with intravenous tranexamic acid (500 mg) without requiring nasal packing. No complications occurred in the remaining patients, and no long-term complications were observed in any case. Conclusion: Septoplasty was performed using multiple continuous trans-septal sutures after initial quilting sutures for stabilizing the corrected septum with absorbable 4-0 Vicryl suturing material, without nasal packing or splints, is an effective method for preventing hematoma and synechiae. This technique also avoids the discomfort and complications associated with foreign material inside the nasal cavity. Thus, septoplasty can be safely performed as a daycare procedure.

Keywords

septoplasty, nasal packing, nasal splints, quilting sutures, continuous trans-septal sutures

Recommended Citation

Al Badran, Jafar Fawzi and Al Abboodi, Huda Hassan (2025) "Septoplasty without packing or splints: Our experience," Iraqi National Journal of Medicine: Vol. 7 : Iss. 2 , Article 12.
Available at: https://doi.org/10.37319/