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

Conclusion: The patients who underwent septoplasty with bilateral totally occlusive nasal packing had an increased risk of experiencing respiratory distress (RD). Objective: To compare the immediate RD rates during recovery from anesthesia and surgical complications of totally occlusive nasal pack, internal nasal splint, and transseptal suture technique. Methods: A total of 150 patients were assigned to one of three groups according to the technique utilized following septoplasty: transseptal suturing, internal nasal splint, or Merocel (nasal dressing without airway). To determine RD related to anesthesia in the operating theatre, the criterion was defined as any unanticipated hypoxemia, hypoventilation or upper airway obstruction (stridor or laryngospasm) requiring an active and specific intervention. Postoperative hemorrhage, infection, synechia formation, and septal perforation were evaluated. Results: Patients in the Merocel group were 3.6 times more likely to have RD than patients in the transseptal suture and internal nasal splint groups. Also, patients who smoked had an increased risk of RD during the recovery phase of anesthesia after the septoplasty. In addition, all three techniques resulted in similar complication rates after septoplasty, with the exception of minor hemorrhage, which had a significantly higher rate in the transseptal suture group.