The application of no nasal packing after functional endoscopic sinus surgery in type I and type II chronic sinusitis / 临床耳鼻咽喉头颈外科杂志

ABSTRACT

OBJECTIVE@#The subjective sensation of the patients and the treatment effect were compared prospectively between the no nasal packing group and the common nasal packing group.@*METHOD@#The patients were divided into no nasal packing group and nasal packing group matched for the type of chronic sinusitis. All patients received operation of functional endoscopic sinus surgery. The patients of no nasal packing group were given thoroughly bleeding control without nasal packing, while the patients of nasal packing group received nasal packing with sponge after hemostatic seaweed covering of wound. The nasal stents in nasal packing group were removed two days after operation, and the other treatments were all identical in the two groups. The clinical symptoms and treatment effect were compared between the two groups using visual analog scale. The levels of headache, rhinalgia, nasal obstruction, bleeding and nasal secretions volume at different time points, such as 1 day, 2 days and 3 days after operation, were evaluated and compared, as well as the recovering of operative region, such as crustal, secretion, reaction film, mucosal edema, vesicle and blockage of the sinus ostium.@*RESULT@#At the 1st day after operation, the degrees of headache, rhinalgia and nasal obstruction in the no nasal packing group were milder than the nasal packing group, and the differences have statistical significance. Two days after operation, the degrees of headache, rhinalgia and nasal obstruction, as well as the volume of bleeding and nasal secretions in the no nasal packing group were milder and lower than the nasal packing group, and the differences have statistical significance. Three days after operation, the differences of the indexes above were not statistically significant. The scores of total bleeding volume during the 3 days after operation showed no statistically significant difference between the two groups. Thirty-four patients were cured in no nasal packing group with the average epithelialization time of (10.7 +/- 2.6) weeks. Thirty-two patients were cured in nasal packing group with the average epithelialization time of (10.6 +/- 2.9) weeks. The difference of average epithelialization time between the two groups was not statistically significant.@*CONCLUSION@#No nasal packing could relieve the discomfort caused by nasal packing and avoid the rebleeding and pain when removing the nasal stents. No nasal packing has obvious superiority than common nasal packing, and is effective in the treatment of depression. It is be appropriate for type I and type II chronic sinusitis patients without systemic disease with limited economic conditions.