EFFECT OF COMPLETELY OCCLUSIVE NASAL PACK VERSUS NASAL PACK WITH AIRWAY ON EUSTACHIAN TUBE FUNCTION AND ARTERIAL BLOOD GAS- A RANDOMISED CONTROLLED TRIAL

Abstract

BACKGROUND: Nasal packing is a common procedure in otorhinolaryngology used to manage epistaxis and support nasal structures following surgery. While being effective, the occlusion caused by nasal packing can impact on oxygen saturation and Eustachian tube function. This study compares the effects of totally occlusive nasal packing and nasal packing with an airway on Arterial blood gas and Eustachian tube function. OBJECTIVES: 1. To document the effect of totally occlusive anterior nasal pack on Eustachian tube function and arterial blood gas. 2. To document the effect of anterior nasal pack with airways on Eustachian tube function and arterial blood gas. 3. To compare the effects of totally occlusive anterior nasal pack and nasal pack with airways on Eustachian tube function and arterial blood gas analysis. METHODS: This randomized controlled study was conducted over 1 year and 8 months at RL Jalappa Hospital and Research Centre. Patients aged 18-60 years requiring nasal packing for epistaxis or following nasal surgery were included. Patients were randomly assigned to two groups: Group A (totally occlusive nasal packs) and Group B (nasal packs with airways). Tympanometry, arterial blood gas (ABG) analysis and oxygen saturation monitoring was done pre- op, post- op day 1 with nasal packing. xvi RESULTS: The study included 62 patients, equally distributed between the two groups with no significant differences in age or gender distribution. Patients with totally occlusive nasal pack showed a more pronounced effect on reducing middle ear ventilation and altering arterial blood gas parameters and more negative effect on oxygen saturation compared to patients with airway pack. CONCLUSION: Nasal packing with an airway appears to mitigate some of the adverse effects on Eustachian tube function and arterial blood gases compared to totally occlusive nasal packing. These findings suggest that incorporating an airway in nasal packing could enhance patient safety and comfort, especially in those with pre-existing respiratory or cardiac conditions.