A comparison of the effects of packing or transseptal suture on polysomnographic parameters in septoplasty
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RHINOLOGY
A comparison of the effects of packing or transseptal suture on polysomnographic parameters in septoplasty Murat Turhan • Aslı Bostancı • Mehmet Akdag Oktay Dinc
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Received: 7 June 2012 / Accepted: 19 September 2012 / Published online: 5 October 2012 Ó Springer-Verlag Berlin Heidelberg 2012
Abstract Our objective is to examine the effects of using nasal packing or transseptal suture in septoplasty in young patients, specifically on the polysomnographic parameters in the post-operative period. A total of 43 patients who had undergone septoplasty surgery after a diagnosis of septum deviation were included in the study. Packing was inserted in 23 patients, and transseptal suture was performed in the other 20 patients. A polysomnography test was performed on the patients on the first day after surgery and during the post-operative period. A postoperative increase was found in the apnea–hypopnea index (AHI) within both the packing and suture groups. The AHI increase in the packing group was statistically significant (p \ 0.05). In the post-operative period, the fall in average oxygen desaturation in the packing group was significantly higher compared to suture group (p \ 0.001). In addition, the arousal index was significantly higher in the packing group (p \ 0.05). The use of nasal packing in young patients after septoplasty surgery reduced the quality of life after surgery and had negative effects on respiration during sleep. The finding that nasal
This study was awarded as poster announcement 2nd in 7. Turkish Rhinology Congress (19–22 May 2011). M. Turhan (&) A. Bostancı M. Akdag O. Dinc Department of Otorhinolaryngology, Akdeniz University School of Medicine, 07030 Antalya, Turkey e-mail: [email protected] A. Bostancı e-mail: [email protected] M. Akdag e-mail: [email protected] O. Dinc e-mail: [email protected]
packing caused obstructive sleep apnea syndrome even in young patients leads us to hypothesise that the effect of the packing on comorbid patients’ respiratory function during sleep would be even more severe. Keywords Septoplasty Nasal packing Transseptal suture Polysomnography
Introduction Septal deviation is frequently observed, but it is often clinically asymptomatic. Nasal congestion and difficulty in breathing through the nose caused by septal deviation are two symptoms commonly observed in practical otorhinolaryngology. The purpose of septoplasty surgery is to remedy the symptoms related to the nasal congestion without damaging the physiology of the nose. The reasons for the placement of packing after septoplasty surgery are to control post-surgery bleeding, to fix the cartilage, and to prevent synechia and septal hematoma [1, 2]. There are no general standards concerning the indications of intranasal packing, the duration of the packing, or the type of material used [1]. To avoid unwanted complications, studies are being performed regarding the contents of the packing, the duration of its presence within the nose, and methods of implementation [3
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