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David Reiter, MD, DMD; Eugene Alford, MD; Zaven Jabourian, MD

Arch Otolaryngol Head Neck Surg. 1989;115(10):1203-1205.

Abstract
• Nasal packing is considered routine by most physicians and patients at the completion of nasal and septal surgery. Yet the rationale for this maneuver is not clearly defined by reported investigation or logical analysis. We discuss 75 consecutive nasal surgical procedures completed without packing. There were two postoperative episodes of bleeding, both from pyriform aperture incisions for lateral osteotomy and both managed in the recovery room with an absorbable gelatin sponge. Technical refinements such as scrupulous preoperative history taking, through-and-through suturing of the entire septal flaps, small-caliber osteotomy, meticulous closure of all intranasal incisions, and proper application of a conforming dressing are essential for hemostasis. We offer specific procedural guidance to minimize the risk of postoperative nasal bleeding.

(Arch Otolaryngol Head Neck Surg. 1989;115:1203-1205)

Author Affiliations
From the Center for Facial Plastic Surgery of Thomas Jefferson University Hospital, and the Department of Otolaryngology, Jefferson Medical College of Thomas Jefferson University Hospital, Philadelphia, Pa.

Footnotes
Accepted for publication June 1, 1989.

Presented at the Southern Section Meeting of the American Academy of Facial Plastic and Reconstructive Surgery, Naples, Fla, January 12, 1989.

Reprint requests to 808 Times Bldg, Suburban Square, Ardmore, PA 19003 (Dr Reiter).

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