This Turkish study aimed to investigate the effects of different types of nasal packings on middle ear pressure in patients undergoing septoplasty. The authors reference several articles that describe eustachian tube dysfunction, temporary ear fullness and mild pain due to the use of nasal packing after septoplasty. Sixty patients were randomised to have either merocel packs or intranasal silicone splints following septal surgery; middle ear pressure was measured using tympanometry. Interestingly, there was no control group; the use of a control group might have provided a useful comparison between packing and not packing after surgery. There is a current vogue for the use of dissolvable packs following nasal surgery, but these did not feature in the study. The study draws the conclusion that merocel packing placed in the nasal cavities after nasal surgery caused a higher decrease in the middle ear pressure compared with the silicone intranasal splint. The authors explain this by stating that merocel packs cause eustachian dysfunction due to a mechanical obstruction extending to the nasopharynx. They do not state which size of merocel pack was used, nor whether the packs were trimmed appropriately. The authors also conclude that cannulated silicone intranasal splints are better in terms of patient comfort after intranasal surgery. However, patient comfort was not addressed or measured as part of the current study.

Is middle ear pressure effected by nasal packings after septoplasty?
Şereflican M, Yurttaş V, Oral M, Yılmaz B, Dağlı M.
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Emma Stapleton

Manchester Royal Infirmary, UK.

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