Skip to main content
Erschienen in: European Archives of Oto-Rhino-Laryngology 11/2017

15.09.2017 | Rhinology

Comparison on effectiveness of trans-septal suturing versus nasal packing after septoplasty: a systematic review and meta-analysis

verfasst von: Wei-Wei Wang, Bao-Cheng Dong

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 11/2017

Einloggen, um Zugang zu erhalten

Abstract

This systematic review applied meta-analytic procedures to evaluate the curative effect of trans-septal suturing versus nasal packing after septoplasty. Computerized search of the published literature in PubMed, EMBASE, CENTRAL, Cochrane Database of Systematic Reviews, WANFANG, CNKI databases. Randomized trials investigating trans-septal suturing versus nasal packing following septoplasty in patients with deviated nasal septum. Adhesion, septal hematoma, bleeding, septal perforation, infection, pain, headache, or residual septal deviation per randomized patients. 19 randomized controlled trials of 1845 subjects were included. Meta-analysis showed that postoperative pain, headache, and adhesion were significantly lower in trans-septal suturing group. Nasal packing and trans-septal suturing technique appear to be equivalent with regard to postoperative bleeding, hematoma, septal perforation, infection, and residual septal deviation. Trans-septal suturing technology is not only associated with less patient pain, headache, and lower occurrence rate of adhesion after septoplasty but it also relates to higher patient satisfaction and an improved quality of life. The suturing technology can be used as a substitute for traditional nasal packing of the first-line treatment. More well-designed studies are needed to confirm the effect of trans-septal suturing following septoplasty.
Literatur
1.
Zurück zum Zitat Fettman N, Sanford T, Sindwani R (2009) Surgical management of the deviated septum: techniques in septoplasty. Otolaryngol Clin N Am 42:241CrossRef Fettman N, Sanford T, Sindwani R (2009) Surgical management of the deviated septum: techniques in septoplasty. Otolaryngol Clin N Am 42:241CrossRef
2.
Zurück zum Zitat Weber R, Hochapfel F, Draf W (2000) Packing and stents in endonasal surgery. Rhinology 38:49–62PubMed Weber R, Hochapfel F, Draf W (2000) Packing and stents in endonasal surgery. Rhinology 38:49–62PubMed
3.
Zurück zum Zitat Cukurova I, Cetinkaya EA, Mercan GC, Demirhan E, Gumussoy M (2012) Retrospective analysis of 697 septoplasty surgery cases: packing versus trans-septal suturing method. Acta Otorhinolaryngol Ital 32:111–114PubMedPubMedCentral Cukurova I, Cetinkaya EA, Mercan GC, Demirhan E, Gumussoy M (2012) Retrospective analysis of 697 septoplasty surgery cases: packing versus trans-septal suturing method. Acta Otorhinolaryngol Ital 32:111–114PubMedPubMedCentral
4.
Zurück zum Zitat Shaw C-KL, Cowin A (2000) Effect of packing on nasal mucosa of sheep. J Laryngol Otol 114:506PubMed Shaw C-KL, Cowin A (2000) Effect of packing on nasal mucosa of sheep. J Laryngol Otol 114:506PubMed
5.
Zurück zum Zitat Veluswamy A, Handa S, Shivaswamy S (2012) Nasal septal clips: an alternative to nasal packing after septal surgery? Ind J Otolaryngol Head Neck Surg 64:346–350CrossRef Veluswamy A, Handa S, Shivaswamy S (2012) Nasal septal clips: an alternative to nasal packing after septal surgery? Ind J Otolaryngol Head Neck Surg 64:346–350CrossRef
6.
Zurück zum Zitat Hari C, Marnane C, Wormald PJ (2008) Quilting sutures for nasal septum. J Laryngol Otol 122:522CrossRefPubMed Hari C, Marnane C, Wormald PJ (2008) Quilting sutures for nasal septum. J Laryngol Otol 122:522CrossRefPubMed
7.
Zurück zum Zitat Kula M, Yuce I, Unlu Y, Tutus A, Caglı S, Ketencı I (2010) Effect of nasal packing and haemostatic septal suture on mucociliary activity after septoplasty: an assessment by rhinoscintigraphy. Eur Arch Otorhinolaryngol 267:541–546CrossRefPubMed Kula M, Yuce I, Unlu Y, Tutus A, Caglı S, Ketencı I (2010) Effect of nasal packing and haemostatic septal suture on mucociliary activity after septoplasty: an assessment by rhinoscintigraphy. Eur Arch Otorhinolaryngol 267:541–546CrossRefPubMed
8.
Zurück zum Zitat Özkırış M, Kapusuz Z, Saydam L (2013) Comparison of nasal packs with transseptal suturing after nasal septal surgery. Am J Otolaryngol 34:308CrossRefPubMed Özkırış M, Kapusuz Z, Saydam L (2013) Comparison of nasal packs with transseptal suturing after nasal septal surgery. Am J Otolaryngol 34:308CrossRefPubMed
9.
Zurück zum Zitat Alraggad DK, Eljundi AM, Almomani OS, Alserhan MM, Nawasrah OO, Qhawi MA, Husban AM (2007) Suturing of the nasal septum after septoplasty, is it an effective alternative to nasal packing? Saudi Med J 28:1534–1536 Alraggad DK, Eljundi AM, Almomani OS, Alserhan MM, Nawasrah OO, Qhawi MA, Husban AM (2007) Suturing of the nasal septum after septoplasty, is it an effective alternative to nasal packing? Saudi Med J 28:1534–1536
10.
Zurück zum Zitat Ardehali MM, Bastaninejad S (2009) Use of nasal packs and intranasal septal splints following septoplasty. Int J Oral Maxillofac Surg 38:1022–1024CrossRefPubMed Ardehali MM, Bastaninejad S (2009) Use of nasal packs and intranasal septal splints following septoplasty. Int J Oral Maxillofac Surg 38:1022–1024CrossRefPubMed
11.
Zurück zum Zitat Korkut AY, Teker AM, Eren SB, Gedikli O, Askiner O (2010) A randomised prospective trial of trans-septal suturing using a novel device versus nasal packing for septoplasty. Rhinology 48:179–182PubMed Korkut AY, Teker AM, Eren SB, Gedikli O, Askiner O (2010) A randomised prospective trial of trans-septal suturing using a novel device versus nasal packing for septoplasty. Rhinology 48:179–182PubMed
12.
Zurück zum Zitat Özbal Koç AE, Türkoğlu BS, Kibar SS, Büyüklü F (2016) A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation? Kulak Burun Boğaz Ihtisas Dergisi KBB J Ear Nose Throat 26:152CrossRef Özbal Koç AE, Türkoğlu BS, Kibar SS, Büyüklü F (2016) A comparative study on nasal packing after septoplasty: does it matter in terms of patient comfort, bleeding, and crust or synechia formation? Kulak Burun Boğaz Ihtisas Dergisi KBB J Ear Nose Throat 26:152CrossRef
13.
Zurück zum Zitat Naghibzadeh B, Peyvandi AA, Naghibzadeh G (2011) Does post septoplasty nasal packing reduce complications? Acta Med Iran 49:9PubMed Naghibzadeh B, Peyvandi AA, Naghibzadeh G (2011) Does post septoplasty nasal packing reduce complications? Acta Med Iran 49:9PubMed
14.
Zurück zum Zitat Cayonu M, Acar A, Horasanlı E, Altundag A, Salihoglu M (2014) Comparison of totally occlusive nasal pack, internal nasal splint, and transseptal suture technique after septoplasty in terms of immediate respiratory distress related to anesthesia and surgical complications. Acta Otolaryngol 134:390–394CrossRefPubMed Cayonu M, Acar A, Horasanlı E, Altundag A, Salihoglu M (2014) Comparison of totally occlusive nasal pack, internal nasal splint, and transseptal suture technique after septoplasty in terms of immediate respiratory distress related to anesthesia and surgical complications. Acta Otolaryngol 134:390–394CrossRefPubMed
15.
Zurück zum Zitat Plasencia DP, Falcón JC, Barreiro SB, Bocanegra-Pérez MS, Barrero MV, Macías ÁR (2016) Transeptal suturing—a cost-efficient alternative for nasal packing in septal surgery. Braz J Otorhinolaryngol 82:310–313CrossRefPubMed Plasencia DP, Falcón JC, Barreiro SB, Bocanegra-Pérez MS, Barrero MV, Macías ÁR (2016) Transeptal suturing—a cost-efficient alternative for nasal packing in septal surgery. Braz J Otorhinolaryngol 82:310–313CrossRefPubMed
16.
Zurück zum Zitat Eşki E, Güvenç IA, Hızal E, Yılmaz I (2014) Effects of nasal pack use on surgical success in septoplasty. Kulak Burun Boğaz Ihtisas Dergisi KBB J Ear Nose Throat 24:206CrossRef Eşki E, Güvenç IA, Hızal E, Yılmaz I (2014) Effects of nasal pack use on surgical success in septoplasty. Kulak Burun Boğaz Ihtisas Dergisi KBB J Ear Nose Throat 24:206CrossRef
17.
Zurück zum Zitat Ghimire A, Limbu TR, Bhandari R (2012) Trans-septal suturing following septoplasty: an alternative for nasal packing. Nepal Med Coll J 14:165–168PubMed Ghimire A, Limbu TR, Bhandari R (2012) Trans-septal suturing following septoplasty: an alternative for nasal packing. Nepal Med Coll J 14:165–168PubMed
18.
Zurück zum Zitat Günaydın RÖ, Aygenc E, Karakullukcu S, Fidan F, Celikkanat S (2011) Nasal packing and transseptal suturing techniques: surgical and anaesthetic perspectives. Eur Arch Otorhinolaryngol 268:1151–1156CrossRefPubMed Günaydın RÖ, Aygenc E, Karakullukcu S, Fidan F, Celikkanat S (2011) Nasal packing and transseptal suturing techniques: surgical and anaesthetic perspectives. Eur Arch Otorhinolaryngol 268:1151–1156CrossRefPubMed
19.
Zurück zum Zitat Li D, Wang W, Lin Y (2016) Application of continuous sutures for nasal septum after septoplasty. J Clin Otorhinolaryngol Head Neck Surg (China) 30:381–382 Li D, Wang W, Lin Y (2016) Application of continuous sutures for nasal septum after septoplasty. J Clin Otorhinolaryngol Head Neck Surg (China) 30:381–382
20.
Zurück zum Zitat Mustafa S, Abdulrazzaq AF (2015) Effect of transseptal suture technique versus nasal packing after septoplasty. Int J Tech Res Appl 3(4):33–40 Mustafa S, Abdulrazzaq AF (2015) Effect of transseptal suture technique versus nasal packing after septoplasty. Int J Tech Res Appl 3(4):33–40
21.
Zurück zum Zitat Nunez DA, Martin FW (1991) An evaluation of post-operative packing in nasal septal surgery. Clin Otolaryngol Allied Sci 16:549–550CrossRefPubMed Nunez DA, Martin FW (1991) An evaluation of post-operative packing in nasal septal surgery. Clin Otolaryngol Allied Sci 16:549–550CrossRefPubMed
22.
Zurück zum Zitat Shao Y, Zhao R, Li H (2016) Treatment effect of continuous suture technique for nasal septum after septoplasty. Chin Arch Otolaryngol Head Neck Surg 23:599–601 Shao Y, Zhao R, Li H (2016) Treatment effect of continuous suture technique for nasal septum after septoplasty. Chin Arch Otolaryngol Head Neck Surg 23:599–601
23.
Zurück zum Zitat Thapa N, Pradhan B (2011) Postoperative complications of septal quilting and BIPP packing following septoplasty. J Nepal Health Res Council 9:186 Thapa N, Pradhan B (2011) Postoperative complications of septal quilting and BIPP packing following septoplasty. J Nepal Health Res Council 9:186
24.
Zurück zum Zitat Wang M, Xing Z, Yuan X, Liu Y, Han L, Qin N (2011) Effect of nasal septal suture versus nasal packing after septoplasty. J Clin Otorhinolaryngol Head Neck Surg (China) 25:1068–1070 Wang M, Xing Z, Yuan X, Liu Y, Han L, Qin N (2011) Effect of nasal septal suture versus nasal packing after septoplasty. J Clin Otorhinolaryngol Head Neck Surg (China) 25:1068–1070
25.
Zurück zum Zitat Yang MB, Zhang YH, Xia XL, Qiu SQ, Zhao HL, Lan JP (2013) SkilI of continuous sutures for nasal septum after septoplasty. Chin Arch Otolaryngol Head Neck Surg 20:349–352 Yang MB, Zhang YH, Xia XL, Qiu SQ, Zhao HL, Lan JP (2013) SkilI of continuous sutures for nasal septum after septoplasty. Chin Arch Otolaryngol Head Neck Surg 20:349–352
26.
Zurück zum Zitat Bajaj Y, Kanatas AN, Carr S, Sethi N, Kelly G (2009) Is nasal packing really required after septoplasty? Int J Clin Pract 63:757–759CrossRefPubMed Bajaj Y, Kanatas AN, Carr S, Sethi N, Kelly G (2009) Is nasal packing really required after septoplasty? Int J Clin Pract 63:757–759CrossRefPubMed
27.
Zurück zum Zitat Lemmens W, Lemkens P (2001) Septal suturing following nasal septoplasty, a valid alternative for nasal packing? Acta Otorhinolaryngol Belg 55:215–221PubMed Lemmens W, Lemkens P (2001) Septal suturing following nasal septoplasty, a valid alternative for nasal packing? Acta Otorhinolaryngol Belg 55:215–221PubMed
28.
Zurück zum Zitat Dobratz EJ, Park SS (2009) Septoplasty pearls. Otolaryngol Clin N Am 42:527–537CrossRef Dobratz EJ, Park SS (2009) Septoplasty pearls. Otolaryngol Clin N Am 42:527–537CrossRef
29.
Zurück zum Zitat Weber R, Keerl R, Hochapfel F, Draf W, Toffel PH (2001) Packing in endonasal surgery. Am J Otolaryngol 22:306–320CrossRefPubMed Weber R, Keerl R, Hochapfel F, Draf W, Toffel PH (2001) Packing in endonasal surgery. Am J Otolaryngol 22:306–320CrossRefPubMed
30.
Zurück zum Zitat He FC, Chen TR, Cui J, Zhong ZZ (2007) Comparative study of nasal and nasal sinus stuffing materials after endoscopic sinus surgery. Chin Arch Otolaryngol Head Neck Surg 21:276–277 He FC, Chen TR, Cui J, Zhong ZZ (2007) Comparative study of nasal and nasal sinus stuffing materials after endoscopic sinus surgery. Chin Arch Otolaryngol Head Neck Surg 21:276–277
31.
Zurück zum Zitat Turhan M, Bostancı A, Akdag M, Dinc O (2013) A comparison of the effects of packing or transseptal suture on polysomnographic parameters in septoplasty. Eur Arch Otorhinolaryngol 270:1339CrossRefPubMed Turhan M, Bostancı A, Akdag M, Dinc O (2013) A comparison of the effects of packing or transseptal suture on polysomnographic parameters in septoplasty. Eur Arch Otorhinolaryngol 270:1339CrossRefPubMed
32.
Zurück zum Zitat Lee IN, Vukovic L (1988) Hemostatic suture for septoplasty: how we do it. J Otolaryngol 17:54–56PubMed Lee IN, Vukovic L (1988) Hemostatic suture for septoplasty: how we do it. J Otolaryngol 17:54–56PubMed
33.
Zurück zum Zitat Awan MS, Iqbal M (2008) Nasal packing after septoplasty: a randomized comparison of packing versus no packing in 88 patients. Ear Nose Throat J 87:624PubMed Awan MS, Iqbal M (2008) Nasal packing after septoplasty: a randomized comparison of packing versus no packing in 88 patients. Ear Nose Throat J 87:624PubMed
34.
Zurück zum Zitat Certal V, Silva H, Santos T, Correia A, Carvalho C (2012) Trans-septal suturing technique in septoplasty: a systematic review and meta-analysis. Rhinology 50:236–245PubMed Certal V, Silva H, Santos T, Correia A, Carvalho C (2012) Trans-septal suturing technique in septoplasty: a systematic review and meta-analysis. Rhinology 50:236–245PubMed
35.
Zurück zum Zitat Dai MY, Chen SM, Tao ZZ, Chen C, Li M (2013) Meta analysis of therapy effect of trans-septal suturing technique versus nasal packing in septoplasty. Chin J Clin (electronic edition) 7:3957–3962 Dai MY, Chen SM, Tao ZZ, Chen C, Li M (2013) Meta analysis of therapy effect of trans-septal suturing technique versus nasal packing in septoplasty. Chin J Clin (electronic edition) 7:3957–3962
Metadaten
Titel
Comparison on effectiveness of trans-septal suturing versus nasal packing after septoplasty: a systematic review and meta-analysis
verfasst von
Wei-Wei Wang
Bao-Cheng Dong
Publikationsdatum
15.09.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 11/2017
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-017-4709-2

Weitere Artikel der Ausgabe 11/2017

European Archives of Oto-Rhino-Laryngology 11/2017 Zur Ausgabe

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

HNO-Op. auch mit über 90?

16.04.2024 HNO-Chirurgie Nachrichten

Mit Blick auf das Risiko für Komplikationen nach elektiven Eingriffen im HNO-Bereich scheint das Alter der Patienten kein ausschlaggebender Faktor zu sein. Entscheidend ist offenbar, wie fit die Betroffenen tatsächlich sind.

Intrakapsuläre Tonsillektomie gewinnt an Boden

16.04.2024 Tonsillektomie Nachrichten

Gegenüber der vollständigen Entfernung der Gaumenmandeln hat die intrakapsuläre Tonsillektomie einige Vorteile, wie HNO-Fachleute aus den USA hervorheben. Sie haben die aktuelle Literatur zu dem Verfahren gesichtet.

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.