Septoplasti Sonrası Transseptal Sütür ile Nazal Tamponların Karşılaştırılması

Year 2019, Volume: 3 Issue: 2, 90 - 101, 30.06.2019

Deniz Baklacı , İsmail Güler , İhsan Kuzucu , Rauf Oğzuhan Kum , Müge Özcan

https://doi.org/10.33716/bmedj.567573

Cited By: 3

Abstract

Amaç: Nazal tamponlar septoplasti sonrası yaygın olarak kullanılır.
Bununla birlikte, literatürde nazal tampon kullanımı ile ilişkili çok sayıda
komplikasyon vardır. Bu çalışmada, septoplasti uygulanan hastalarda transseptal
sütür tekniği (TSS) ile üç farklı tip nazal tampon postoperatif komplikasyonlar
ve operasyon sonrası hasta memnuniyeti açısından karşılaştırıldı.

Gereç ve Yöntem: Çalışma grubuna septoplasti uygulanan 80 hasta dahil
edildi: Hastalar 4 gruba ayrıldı. Merocel grubu (grup 1), internal nasal splint
(INS) grubu (grup 2), sentetik poliüretan köpük (SPK) grubu (grup 3) ve TSS
grubu (grup 4). Grupların VAS skorları ağrı (tamponlu kaldığı süre içerisinde,
tamponun çıkarılması sırasında), basınç hissi, disfaji ve postnazal akıntı
açısından karşılaştırıldı. Her grupta kanama, sineşi, septal hematom ve septal
perforasyon gibi komplikasyonlar karşılaştırıldı.

Bulgular: Tamponlu kaldığı süre içerisinde ve tamponların çıkarılması
sırasındaki postoperatif ortalama ağrı, basınç hissi ve disfaji VAS skorları
Merocel grubunda silikon ve Nasopore gruplarına göre anlamlı olarak yüksek
bulundu. Diğer üç grup arasında VAS skorları açısından anlamlı fark yoktu.
Kanama oranı Merocel grubunda en yüksek, TSS grubunda en düşüktü. Sineşi oranı
Merocel grubunda en yüksek, ardından TSS ve SPK grupları ile en düşük INS grubundaydı.
Gruplar arasında septal hematom ve septal perforasyon açısından fark yoktu.

Sonuç: Sonuçlarımız septoplasti hastalarında TSS tekniğinin yüksek hasta
memnuniyeti ve düşük komplikasyon oranları açısından güvenle
kullanılabileceğini göstermiştir. Merocel, yüksek komplikasyon oranları ve
düşük hasta yaşam kalitesi nedeniyle septoplasti için uygun bir materyal gibi
görünmemektedir.

Keywords

Septoplasti, nazal tamponlar, transseptal sütür tekniği

Comparison of the Transseptal Suturing with Nasal Packs After Septoplasty

Abstract

Objective: Nasal packs are commonly used after septoplasty. However,
there are numerous complications associated with nasal packing in the literature.
This study aimed to compare the efficacy of transseptal suture technique (TSS)
versus three different types of nasal packs regarding to postoperative
complications and patient satisfaction after septoplasty. 

Material and Method: The study group included 80 patients who underwent
septoplasty. The patients were randomly divided into four groups: Merocel group
(group 1), internal nasal splint (INS) group (group 2), synthetic polyurethane
foam (SPF) group (group 3) and TSS group (group 4). The VAS scores of groups
were compared for pain (during pack, on removal of the pack), sense of
pressure, dysphagia and postnasal drip. The complications including bleeding,
synechiae, septal hematoma and septal perforation were also compared for each
group. 

Results: The mean VAS scores of postoperative pain during packed and on
removal of packs, sense of pressure and dysphagia found significantly higher in
Merocel group than in silicone and Nasopore groups. There was no significant
difference between other three groups regarding to VAS scores. Bleeding ratio
was highest in Merocel group, and lowest in TSS group. Synechiae ratio was
highest in Merocel group followed by TSS and SPF groups and lowest in INS
group. There was no difference between groups regarding to septal hematoma and
septal perforation.

Conclusion: Our results showed that TSS technique might be safely used
in septoplasty patients regarding to high patient’s satisfaction and low
complication ratios. Merocel does not seem to be an appropiate material for
septoplasty due to its high complication and low patient’s quality of life
ratios. 

Keywords

Septoplasty, nasal packs, transseptal suture technique

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