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Anterior nasal packing in nasal surgeries and epistaxis: advantages of nasal tampon over conventional framycetin ribbon packs

Background: Nasal packs in the form of conventional framycetin ribbon guaze pack and nasal tampons have been used since a long time. Both are very effective in nasal packing for epistaxis and post nasal surgery packing.

Objective: The objective of this study was to compare the outcome of nasal tampon packing and framycetin ribbon guaze packing method for post nasal surgery packing and epistaxis.

Materials and methods: A study of two methods of nasal packing done in 462 patients done from January 2008 to September 2011 for post nasal surgery cases and epistaxis were included in the study. Three parameters were analyzed namely pain (visual analogue scale VAS 10cm), control of hemorrhage and reduction in crusting and adhesions post-operatively.

Result: The average VAS scores with ribbon pack was 4.97 and tampon pack 4.63 and tampon packs caused significantly lesser pain. But Kennedy and Lund grading system scores of crusting and adhesions showed no significant difference.

Conclusion: Framycetin ribbon pack and nasal tampon pack are equally effective in managing bleeding post-operatively in nasal surgeries and epistaxis. No difference in crusting and adhesions were seen among the two packs but lesser pain with pack insitu and at removal were seen with tampon pack. Nasal tampon packs were more comfortable among patients.

Author(s): Sudhir M Naik, Mohan Appaji , Ravishankar S, Goutham MK, AnnapurnaSM5, N Pinky Devi, Sarika S Naik