Septoplasty Operation Without Nasal Packing

Packing-Free Deviated Septum Surgery: A Comfortable and Effective Procedure

Unbuffered septoplasty surgery - Unbuffered nasal septum deviation surgery - Unbuffered septum deviation operation - Unbuffered nose surgery - Unbuffered SMR operation - Unbuffered septum deviation correction surgery - ENTact Septal Stapler

Septoplasty is a common surgical procedure aimed at correcting a deviated septum to improve nasal airflow and alleviate breathing difficulties. Traditionally, nasal packing has been used after septoplasty to support the healing process, prevent bleeding, and reduce the risk of postoperative complications. However, in recent years, there has been a shift towards septoplasty without nasal packing, a technique that offers numerous advantages in terms of patient comfort, recovery time, and overall success.

Understanding Septoplasty

Septoplasty is a surgical procedure that involves the modification and repositioning of the deviated septum to ensure that the nasal passages are straight and unobstructed. A deviated septum can result from injury, congenital factors, or other causes, leading to a range of nasal issues, including difficulty breathing, snoring, recurrent sinus infections, and chronic congestion.

During a traditional septoplasty procedure, the surgeon makes incisions inside the nose to access and reposition the septum. Nasal packing, which is essentially silicones, gauze or other materials inserted into the nasal passages, has been routinely used to help control bleeding and stabilize the septum during the healing process. However, this approach has drawbacks that have led some surgeons to explore septoplasty without nasal packing.

ENTact Septal Stapler 

Septoplasty surgeries can also be done without tampons. Patients with limited cartilaginous sprain can be removed after submucosal removal of the cartilage (submucosal resection) if the nasal septum therapy alone is scheduled for treatment, without deviating the buffer. After the procedure, the cartilage can be removed without using the nasal pad by removing the cartilage from the septum area by suturing the suture material with full-thickness suture material, preventing the formation of dead space and providing mutual pressure. The use of a device called the "ENTact Septal Stapler" (such as an automatic sewing machine) that allows a practical nose septum to be stitched in a reciprocal manner is further facilitated. Below you can see the "ENTact Septal Stapler" product videounu (product manufacturer link >> ENTACT Septal Stapler | Smith & Nephew)

Advantages of Using The Internal Silicone Splint Over The Unbuffered Nose Surgery

However, patients with nasal septum deviations usually have turbinate hypertrophy on the opposite side of the septum deviations. Nasal septum deviation surgery and turbinate radiofrequency procedures are also performed. It is more common practice to use "internal silicone splint", which is made of pure silica with pneumatic hole, allowing the patient to breathe on the median line, which serves as a barrier between the nose and the nose septum when the two processes are done together. After the nose surgery, the nose is usually swollen in the first week and contact points with the nasal septum may occur. Intranasal adhesions may occur between these areas, and the patient may complain of severe nasal obstruction due to the swelling of the nose during the first week after surgery. The use of silicone splint is more advantageous than unbuffered nose surgery when combined with nasal surgery.

Packing-Free Septoplasty Operation With Circular Septal Suture Technique

At the end of the septoplasty operation, after suturing the nasal septum in a circular manner and minimizing the risk of septal hematoma, the operation can be completed without placing any tampon in the nose. In addition, tampons may not be used after operations involving limited septum resection. I generally prefer to use internal silicone splints, which allow the patient to breathe.

Why is a Nasal Packing Used During Septoplasty Operation?

A nasal tampon, often referred to as nasal packing, is sometimes used during septoplasty to help control bleeding, support the healing process, and reduce the risk of postoperative complications. While there are instances where septoplasty can be performed without nasal packing, its use is still common in many cases. Here are the reasons why a nasal tampon may be used during septoplasty:

Hemostasis (Bleeding Control): Nasal packing is an effective means of controlling bleeding during and after septoplasty. The surgical procedure involves making incisions in the nasal septum and modifying the septal cartilage and bone. These incisions can lead to bleeding, and the nasal tampon helps apply pressure to the surgical site to minimize bleeding. It can be especially useful in cases where there is significant bleeding during the procedure.

Stabilization of the Septum: The nasal tampon helps stabilize the septum in its corrected position. This is important for ensuring that the septum heals in the proper alignment and reduces the risk of it reverting to its deviated state. By providing support to the septum, it encourages optimal healing.

Preventing Adhesions (Synechiae): Nasal packing can help prevent the formation of adhesions, also known as synechiae, within the nasal passages. Synechiae are abnormal adhesions or scar tissue that can develop between different parts of the nasal cavity. They can lead to nasal obstruction and other complications. Nasal packing acts as a barrier to reduce the likelihood of synechiae forming.

Reducing Swelling and Edema: Nasal packing can help reduce swelling and edema in the nasal tissues. This can aid in patient comfort and may facilitate breathing through the nose during the initial stages of recovery.

Support for Healing: Nasal packing provides support for the healing process and minimizes the risk of complications, such as septal hematoma, infection, or displacement of the septum. It helps maintain the integrity of the surgical site during the early stages of recovery.

It's important to note that while nasal packing can be beneficial in many cases, it is not always necessary for every septoplasty procedure. Some surgeons may opt for septoplasty without nasal packing, as discussed in the previous article, depending on the specific circumstances and the patient's needs. The decision to use nasal packing or not is typically made by the surgeon based on the individual patient's condition and the complexity of the surgery. Patients should discuss this with their surgeon during the preoperative consultation to understand the approach that will be used in their particular case.

On this website, the link group where you can read the previously published articles I have prepared about the septoplasty operation >>

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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