Efficacy of Balloon Tamponade Versus Merocel Nasal Packs in Endoscopic Sinonasal Surgery: A Randomized Controlled Study
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ORIGINAL ARTICLE
Efficacy of Balloon Tamponade Versus Merocel Nasal Packs in Endoscopic Sinonasal Surgery: A Randomized Controlled Study Pradeep Pradhan1
•
Chappity Preetam1
•
Pradipta Kumar Parida2
Received: 30 July 2020 / Accepted: 23 September 2020 Ó Association of Otolaryngologists of India 2020
Abstract Although absorbable nasal packings have been abundantly used in the recent time, the conventional packings are still used in different sinonasal surgeries in the various parts of the globe due to their lower cost. To compare the effectiveness of the balloon tamponade (Rapid Rhino) with Merocel nasal pack in sinonasal diseases. This study was conducted from July 2018 to July 2019 in a tertiary care referral hospital. Rapid Rhino and Merocel were put in 30 patients and 31 patients, respectively. Pain, bleeding, and mucosal healing was evaluated and compared between two groups postoperatively. The reduction in the pain and postoperative bleeding was significant with balloon tamponade (Rapid Rhino) compared to the Merocel (p \ .05). Although insignificant (p [ 0.05), patients with balloon tamponade nasal packs had less crusting and synechia in the postoperative period. Balloon tamponade (Rapid Rhino) nasal pack can be a better alternative to the Merocel nasal pack in reducing postoperative pain, bleeding, and mucosal damage. Keywords Balloon tamponade Merocel Sinonasal surgery Outcomes
& Pradeep Pradhan [email protected] 1
Department of ENT and Head Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
2
All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
Introduction Although absorbable nasal packings have been abundantly used in recent time, the conventional packings are still used in different sinonasal surgeries in the various parts of the globe due to their lower cost. Their primary role is to reduce postoperative bleeding in patients undergoing various sinonasal surgeries [1]. Although adequate hemostasis can be achieved in the intraoperative periods, they are not free of some inherent disadvantages, i.e., pain, bleeding, and mucosal damage, significantly contributing to the postoperative morbidity (scarring/synechia). Both ribbon gauze and Merocel (Medtronic Xomed, Jacksonville, Florida, USA) are the standard nasal packs used in the past in the sinonasal surgeries showing variable postoperative results [2]. Merocel (size 8 cm 9 1.5 cm 9 2 cm) is made up of hydroxylated polyvinyl acetate, which swells in the nasal cavity producing constant lateral pressure over the mucosal blood vessels to control the bleeding [3]. Keeping in mind the unavoidable complications attributed to the conventional nasal packs (ribbon gauze and Merocel), balloon tamponade (Rapid Rhino) can be effectively tried in sinonasal surgeries for a better clinical outcome in the postoperative period. Rapid Rhino (Arthrocare, Knaresborough, UK) consists of an inflatable balloon coated with carboxymethylcellulose (CMC), which promotes the clotting of blood by augmenting platelet
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