A Comparative Study of Pain and Discomfort in Septoplasty with Quilting of Nasal Septum and Nasal Packing

Introduction: Rhinologists have to be aware of the excruciating pain exerted by nasal packs on its introduction and removal. Thus the validity of need for nasal packing following septoplasty is considered under study for its most painful symptom. Objective: To compare the degree of pain and discomfort in patients with quilting of nasal septum and nasal packing after septoplasty using visual analogue score (VAS) Methodology: This is a prospective study done in Kathmandu Medical College in the department of ENT-HN Surgery from January2016 to December 2016.Total of 100 patients undergoing septoplasty for symptomatic deviated nasal septum were included in the study. Severity of degree of pain and discomfort was collected using Visual Analogue Scale (VAS)for the total number of patients with nasal packing and quilting on the day of operation, first post operative day, day of nasal pack removal, day of discharge and first /second follow ups. Results: Level of pain experienced by patients with quilting on the day of operation, first post operative day, on the day of discharge and first follow up were significantly less than those with packing with p value <0.001 in all VAS reading. On the day of pack removal, 29 patients with packing felt most excruciating pain with visual analogue score 10. Eighteen had visual analogue score 9 and only 2 patients felt little pain with visual analogue score of 2. Patients with quilting did not have to bear this level of pain. Conclusion: Quilting of nasal septum after septal surgeries can be used to avoid pain and discomfort caused by nasal packing. Thus packing of nasal cavity should be avoided where possible and reserved for only those who have bleeding predisposition or complications.