Effect of Anterior Nasal Packing on Middle Ear Pressure

Authors

  • Fazle Elahi Jonaed Senior Registrar, ENT- HNS, KhwajaYunus Ali Medical College and Hospital, Enayetpur, Sirajgonj, Bangladesh
  • M Alamgir Chowdhury Head of the department of ENT-HNS, Anwer Khan Modern Medical College and Hospital, Dhaka, Bangladesh
  • Md Iqbal Hossen ENT-HNS, Anwer Khan Modern Medical College and Hospital, Dhaka, Bangladesh
  • Milon Kazi Assistant Registar, ENT-HNS, Bangladesh Medical College and Hospital, Dhaka, Bangladesh
  • Shaikh Nurul Fattah Rumi Head of the department, ENT-HNS, Dhaka Medical College and Hospital, Dhaka, Bangladesh
  • Husne Qumer Osmany Associate Professor, ENT-HNS, Dhaka Medical College and Hospital, Dhaka, Bangladesh

DOI:

https://doi.org/10.3329/bjo.v28i2.64296

Keywords:

ANS packing, middle ear pressure, otological symptom

Abstract

Background: Bilateral anterior nasal packing is often done after septal surgery for hemostatic reasons and mechanical splinting. It has been suggested that nasal packing following septal surgery is a frequent cause of short term eustachian tube dysfunction such as ear fullness and mild pain.

Objectives: To evaluate the effect of anterior nasal packing on middle ear pressure.

Methods: For this prospective, longitudinal study, ninety-two (92) patients admitted for routine septal surgeries were selected according to inclusion and exclusion criteria from the in-patient Department of ENT and Head &Neck Surgery, Dhaka Medical College and Hospital, Dhaka during 1st January 2020 to 31st July 2021. Following informed written consent, the patients were interviewed three times: preoperative, after 24 hours of ANS pack and 6 days after pack removal. During each time, middle ear pressure was measured by an impedance audiometer. Any otological symptoms produced when ANS pack was in place for 24 hours and 6 days after pack removal were also observed and recorded.

Results: Among 92 patients in this study, mean preoperative middle ear pressure was -5.5 (± 30.14) daPa. After 24 hours of anterior nasal packing, 70 ears (38%) showed abnormal middle ear pressure among 184 ears. Mean middle ear pressure after 24 hours of ANS pack was -76.5 (± 58.8) daPa. Middle ear pressure again measured after 6 days of removal of ANS pack and showed that the middle ear pressure of all the patients were within normal range. Mean middle ear pressure was -12.4(± 36.5) daPa after 6 days of pack removal. Some otological symptoms developed due to change in middle ear pressure following ANS pack like ear fullness, earache and tinnitus. All these symptoms subsided after 6 days of pack removal.

Conclusion: Anterior nasal packing decreases middle ear pressure which is reversible and returns to normal 6 days after pack removal. Some otological symptoms developed due to change in middle ear pressure which were transient and all came to normal after 6 days of pack removal.

Bangladesh J Otorhinolaryngol 2022; 28(2): 135-140

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Published

2023-03-02

How to Cite

Jonaed, F. E. ., Chowdhury, M. A. ., Hossen, M. I. ., Kazi, M. ., Rumi, S. N. F. ., & Osmany, H. Q. . (2023). Effect of Anterior Nasal Packing on Middle Ear Pressure. Bangladesh Journal of Otorhinolaryngology, 28(2), 135–140. https://doi.org/10.3329/bjo.v28i2.64296

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Original Articles