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Nasal fractures are commonly treated using nasal packing as an internal splint after performing closed reduction. Although gauze and polyvinyl alcohol sponge (PVAS) are both commonly used for packing, few reports have compared their efficacy and safety in nasal fracture treatment. Therefore, in this study, the authors, aimed to retrospectively compare the efficacy and safety of gauze packing in 208 patients and PVAS packing in 225 patients who underwent closed reduction at our hospital. The proportions of patients requiring revision surgery did not differ significantly between the PVAS and gauze groups ( P =0.627). However, in comparison to the gauze group, the PVAS group displayed significantly fewer instances of uncontrolled epistaxis following packing removal, as well as fewer occurrences of dropout and loss of packing ( P =0.023, P =0.007, and P <0.001, respectively). The results of logistic regression analysis adjusted for confounding factors also showed that compared with the gauze group, the PVAS group was significantly less likely to experience packing dropout (odds ratio=0.13; 95% confidence interval, 0.06-0.29, P <0.001) for which younger and older age and allergic rhinitis were independent risk factors. In conclusion, both gauze and PVAS are effective packing materials as internal splints after closed reduction of nasal bone fractures. Specifically, PVAS utilization warrants consideration in pediatric and geriatric populations, individuals with allergic rhinitis, and those at elevated risk of bleeding., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 by Mutaz B. Habal, MD.)

Aim: The authors aimed to research the effects of autologous platelet-rich plasma, which is known for the positive effects on wound healing, on postoperatif living quality of the patients after using on nasal surgery., Methods: Patients who undergo nasal operation according to randomized patient's choice have been injected with saline merocel pack and platelet-rich plasma (PRP) in their nasal path. Postoperative is followed by 1 month; Nose Obstruction Symptom Evaluation (NOSE) scala score, bleeding, pain, and crust rate have been compared between 2 groups., Results: As a result of the 1 month follow-up, it was seen that the treatment group experienced better results in terms of NOSE scale than the control group patients and this was significant difference in terms of NOSE. Less bleeding and crust was seen on the treatment group patients than the control group patients and statically significant difference was found. In terms of visual analogue scale score no statically significant difference was found between 2 groups., Conclusion: According to the authors' study on PRP, the authors found out that by using PRP wound can be healed faster in early period of postoperative. It was seen with the authors' research that on postoperative early period crusts, bleeding and postoperative complaints are lesser.

Purpose: To compare the effects of 2 nasal packing materials, synthetic polyurethane foam (absorbable) and expandable polyvinyl acetate (nonabsorbable), on the surgical success rate and postoperative complications after endoscopic endonasal dacryocystorhinostomy (EDCR)., Methods: A retrospective medical review of 459 patients (580 eyes) who underwent EDCR for primary acquired nasolacrimal duct obstruction at Korea University Guro Hospitals from January 2009 to February 2014. Surgical success rate (anatomical, functional), postoperative complications (granuloma, synechia, bleeding, and infection) were compared between the 2 groups, absorbable (318 eyes) and nonabsorbable (262 eyes)., Results: The absorbable group showed better results in surgical success rate regarding anatomical (90.5% versus 76.3%, P = 0.00) and functional (89.3% versus 75.9%, P = 0.00). Granulomas developed less frequently in the absorbable group (24.5% versus 38.9%, P = 0.00). Also, bleeding and crust were less frequent in the absorbable group (P = 0.00). Infections were less frequent in the nonabsorbable group (1.52%) compared with the absorbable group (7.86%, P = 0.00). The rate of revision surgery was lower in the absorbable group (7.86% versus 20.9%, P = 0.00). As for the influence of secondary outcomes to the surgical success by multiple logistic regression, granulomas had the largest effect on surgical success either anatomical or functional (odds ratio = 82.393 to anatomical and 44.058 to functional). Synechia had the second largest effect on surgical success (odds ratio = 11.897 to anatomical and 9.605 to functional)., Conclusions: The authors suggest that using a synthetic polyurethane foam as a nasal packing material is not only a surgical option, but also a crucial and essential procedure in EDCR.

Aim: The aim of this study was to investigate the effects of transseptal suturing against 3 different types of nasal packings with respect to pain, operating time, and postoperative complications after nasal septal surgery., Patients and Methods: Two hundred twenty-eight patients (aged between 18 and 58 y) undergoing nasal septal surgery were included in the study. After surgery, 4 types of nasal packing were used: (1) transseptal suturing (group A: 57 patients), (2) internal nasal splint (group B: 57 patients), (3) Merocel standard 8-cm packing without airway (group C: 57 patients), and (4) soft paraffin gauze dressing (group D: 57 patients)., Results: Regarding the mean operating time, there was no statistically significant difference among groups B, C, and D (P > 0.05). However, when the operating times observed in the said 3 groups were compared with those observed in group A, the difference was statistically significant (P < 0.05). The mean (SD) postoperative pain score within 1 to 48 hours was 2.9 (1.3; median, 2) in group A, 6.3 (1.4; median, 6) in group B, 7.5 (1.1; median, 7) in group C, and 7.7 (1.8; median, 7) in group D. Starting from the postoperative 48th hour, internal nasal splint, Merocel packing, and soft paraffin gauze dressing were significantly more painful compared with transseptal suturing (P < 0.05). When compared with the other groups, extubation period and postoperative care unit stay were shorter in the transseptal suturing group (P < 0.05). Regarding infection, hematoma, synechia, or perforation, there was no statistically significant difference among the groups (P > 0.05)., Conclusions: Transseptal suturing technique is a useful alternative to packing, with only a minor increase in operating time. Particularly, transseptal suturing shortens extubation time and postoperative care unit stay.

Objective: We aimed to decrease the postseptoplasty morbidities depending on nasal packing by using Merocel within glove finger moistened with tetracaine 0.25% solution., Study Design: The study was designed as a randomized prospective study., Setting: A university hospital in Turkey., Subjects and Methods: Our study consisted of 80 patients who underwent septoplasty. The Merocel nasal tampon within glove finger was inserted after surgery in the study group and removed after 24 or 48 hours. Merocel was moistened with tetracaine 0.25% solution after insertion into the nasal cavity and just before removal. The morbidities and normal breathing time were recorded and compared with those of the control group., Results: The postseptoplasty morbidities were significantly decreased in the study group compared with those in the control group. The morbidities were also improved after removal of tampons after 24 hours compared with 48 hours. However, the normal breathing time was prolonged when the nasal tampons were removed after 24 hours., Conclusions: The glove finger provides comfortable removal of nasal packing. The Merocel tampons might be safely removed just after 24 hours postoperatively without any complication.

We examined the effects of the duration of keeping a Merocel nasal packing in the nose and the application technique (packing applied either directly or inside a glove finger) on postoperative morbidity and complications. The study included 129 patients (67 males and 62 females; age range 18 to 56 years) undergoing nasal septoplasty without turbinate intervention. The patients were randomly assigned into 4 groups. In group 1 and group 2, Merocel was directly applied in the nasal cavity for 24 hours and 48 hours, respectively; in group 3 and group 4, Merocel was kept in the nasal cavity in a powder-free glove finger for 24 hours and for 48 hours, respectively. Pain and discomfort scores were evaluated by a visual analog scale. The time taken between removal of the tampon and when the patients began to breathe comfortably was called the nasal obstruction time. The differences in mean discomfort score between the groups were not statistically significant (P > 0.05), while the mean pain scores were statistically higher in groups 1 and 2 than in groups 3 and 4 (P < 0.05). The nasal obstruction time was statistically shorter in groups 2 and 4 than in groups 1 and 3 (P < 0.05). Therefore, keeping Merocel inside a glove finger in place for 48 hours notably reduces the pain occurring during the removal of the nasal tampon. It also reduces nasal obstruction time and prevents synechia, leakage, bleeding, and septal hematoma, without compromising patient comfort.

Conchal cartilage grafts are commonly used in rhinoplasties; however, complications related to the donor site, including delayed wound healing and scar formation and hematoma formation, still occur. Hematoma formation is the most important and frequent complication. Conventional tie-over dressing with a bolster has been commonly used to prevent donor-site hematomas, but it does not always give satisfactory outcomes. Therefore, we have introduced a new compressive dressing technique using Merocel, which is cut in half transversely: 1 piece is used as a posterior bolster and the other piece is cut in half again (yielding 2 small pieces) to make a concavity in the conchal cartilage (one piece for cymba concha and the other piece for cavum concha, respectively). After application of Merocel, the overall complication and hematoma formation rates were significantly decreased. Our new compressive dressing technique using Merocel has several advantages. Merocel can absorb more secretions and discharge from the operative site than conventional dressings and there are no risks of tissue necrosis or ischemia due to suture tension. Also, because Merocel can be freely cut and molded and applies even pressure, it can be used on irregular surfaces. Our new compressive dressing technique using Merocel is a simple and reliable option for preventing auricular hematomas.

The primary goals of preoperative embolization of glomus tumors are to reduce the blood loss in the surgical field, minimize the risk of operative complications, and prevent recurrence by contributing to complete resection. Obliteration of a vascular channel may provide additional help in symptomatic relief by decreasing the tumor volume. Selective transarterial embolotherapy outcomes of 17 patients, most of whom had inoperable tumors and were unable to have surgery/radiotherapy because of poor general health, were evaluated to investigate the therapeutic contributions, efficacy, and safety of embolization techniques in the treatment of different glomus tumors and to examine the role of the embolotherapy in the treatment algorithm of such lesions. The pattern of vascular supply of these tumors was also documented. Eleven glomus jugulotympanicum, 4 glomus caroticum, and 2 glomus vagale tumors were embolized for palliative or curative purposes between 1992 and 2000. Coils and combination of coils plus polyvinyl alcohol were used for embolization. Relief of symptoms and patient satisfaction were analyzed within 3 months after the intervention by a questionnaire combined with full ear, nose, and throat and neurological examinations. The results indicate that the use of embolotherapy in the treatment of glomus tumors must be basically preoperative but is not curative.