A posterior pack is placed to occlude the choanal arch and, in conjunction with an anterior nasal pack, provide hemostasis. Posterior packing can be accomplished with gauze, a Foley catheter, a nasal sponge/tampon, or an inflatable nasal balloon catheter.
The following steps can be taken to treat a nosebleed:
- remain calm.
- sit upright, to keep the head above heart level.
- lean forward, to prevent blood entering the throat.
- gently blow out any clotted blood.
- use a nasal decongestant spray, such as oxymetazoline or neo-synephrine.
There are disadvantage of patient discomfort while removing the nasal packing. The packings can be removed 24-48 hours after operation (1). Researchers reports that removing Merocel nasal packing in 24 hour after surgery causes less pain when compared to removing it 48 hour after surgery (1).
The nose packing can be removed approximately two days after this rhinoplasty surgery. This can be performed at home with the help of friends or family. The packing is shaped like a cylinder about the length of one's finger and it has a string on the end to aid in removal.
Once removed, the nurse or doctor may apply pressure with their fingers to the fleshy part of your nose for 3 – 5 minutes. They will check for bleeding after 3 – 5 minutes. If no active bleeding is seen, a bolster dressing will be applied, which can stay in place until you get home.
Conclusion: Placement of nasal packing or other hemostatic agents or both within the nasal cavity is not necessary in the majority of endoscopic sinus surgeries. The risks, costs, and discomforts associated with these interventions can often be avoided.
DISCUSSION. Nasal pain and headache were higher in patients with nasal packing, but this was not statistically significant except for nasal pain at 48 hours.
Nasal packing may or may not be left in place after surgery. If you do have this packing, you will need to return in three or four days to have it removed by your doctor. 15 to 20 minutes.
Background: Nasal packing is routinely used after septoplasty because it is believed to decrease risk of postoperative bleeding, hematomas, and adhesions. Multiple studies have shown, however, that there are numerous complications associated with nasal packing.
After surgery, you may have either dissolvable suture, packing (to stop bleeding) or splints (to hold the tissues in place) inside your nose. Most of the time, packing is removed 24 to 36 hours after surgery. Splints may be left in place for as long as 1 to 2 weeks.
- Mix the saline solution in the bottle.
- Stand over the sink/tub.
- With gentle pressure, push the solution into your nostril.
- Let the solution run into the sink/tub from your nose and mouth.
- Irrigate each nostril with a full bottle of solution 3 to 4 times daily for the first week after the surgery.
In many cases, packs or nasal packing is placed in the nose to control postoperative bleeding. The surgeon will tell the patient when to return to the office to have these packs removed. Patients may need to call the office to schedule this postoperative appointment.
Sleep with the head of the bed elevated until all the dressings have been removed from the nose. To accomplish this, place two (2) or three (3) pillows under the head of the mattress and one (1) or two (2) on top of it. Try not to roll over on your nose.
