Rapid Rhino nasal packs: demonstration of depressurisation but not deflation

Objectives:Following a suggestion by ward patients that Rapid Rhino™ nasal packs may deflate over time, allowing recurrence of epistaxis, we aimed to demonstrate deflation of 7.5 cm Rapid Rhino packs when used in vivo for post-operative nasal packing.Materials and methods:The volume of air insufflated and retrieved from Rapid Rhino nasal packs used for post-operative nasal packing was recorded, as was the pressure following inflation and prior to removal. The time taken for the initial inflation pressure to stabilise was monitored in a number of packs. Similar pressure and volume measurements were repeated in a series of in vitro packs for comparison.Results:Fourteen consecutive patients undergoing septoplasty were recruited. High but unsteady pressure values were obtained in the first patient's packs. In the subsequent five patients, continuous pressure monitoring demonstrated that gradual depressurisation occurred over the first 16 to 22 minutes following inflation. A typical pressure was 35 cmH2O after inflating with 8 ml of air. Only one Rapid Rhino pack was demonstrated to leak air in vivo.Conclusion:When used in vivo, Rapid Rhino nasal packs initially depressurise over a period of about 20 minutes. Actual leakage (deflation) was not demonstrated to be an expected feature of Rapid Rhino packs in this study.