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Histopathological changes of nasal mucosa after nasal packing with Merocel

Published online by Cambridge University Press:  20 December 2021

M Tan Open the ORCID record for M Tan [Opens in a new window] ,
T Bayındır ,
M T Çiçek ,
M Aslan Open the ORCID record for M Aslan [Opens in a new window]  and
M Gül
M Tan*
Affiliation:
Department of Otorhinolaryngology, Inonu University Medical Faculty, Malatya, Turkey
T Bayındır
Affiliation:
Department of Otorhinolaryngology, Inonu University Medical Faculty, Malatya, Turkey
M T Çiçek
Affiliation:
Department of Otorhinolaryngology, Inonu University Medical Faculty, Malatya, Turkey
M Aslan
Affiliation:
Department of Otorhinolaryngology, Inonu University Medical Faculty, Malatya, Turkey
M Gül
Affiliation:
Department of Histology, Inonu University Medical Faculty, Malatya, Turkey
*
Author for correspondence: Dr Mehmet Tan, Department of Otorhinolaryngology, Inonu University Medical Faculty, Malatya, Turkey E-mail: [email protected]
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Abstract

Objective

To determine histopathological changes in nasal mucosa associated with duration of nasal packing with Merocel tampons.

Methods

This study included 24 healthy rabbits, 6 rabbits per group. In group A, no tampon was applied. In group B, Merocel nasal tampons were applied and removed after 24 hours. In group C, the tampons were removed after 48 hours. In group D, the tampons were removed after 5 days. Specimens were obtained from the septum of each rabbit, including cartilage. Histopathological examination was performed.

Results

Significant differences were observed in terms of inflammatory infiltration and loss of cilia between groups A and B. Significant differences were also observed in terms of inflammatory infiltration, haematoma, cilia loss, epithelium dysplasia and cartilage degeneration between groups B and C. There were significant differences in terms of cilia loss, epithelium dysplasia and subepithelial fibrosis between groups C and D. Cartilage degeneration was mild in one animal in group B and in two animals in group C, and was moderate in four animals in group C.

Conclusion

It is recommended that Merocel nasal tampons are removed within 48 hours to preserve nasal mucosal function. Keeping the pack longer may cause cartilage degeneration and other complications.

Keywords

EpistaxisSeptoplastyNasal Packing
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 8 , August 2022 , pp. 750 - 754
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr M Tan takes responsibility for the integrity of the content of the paper

References

Iqbal, IZ, Jones, GH, Dawe, N, Mamais, C, Smith, ME, Williams, RJ et al. Intranasal packs and haemostatic agents for the management of adult epistaxis: systematic review. J Laryngol Otol 2017;131:1065–9210.1017/S0022215117002055CrossRefGoogle ScholarPubMed
Weber, R, Hochapfel, F, Draf, W. Packing and stents in endonasal surgery. Rhinology 2000;38:49–62Google ScholarPubMed
Weber, R, Keerl, R, Hochapfel, F, Draf, W. Packing in endonasal surgery. Am J Otolaryngol 2001;22:306–2010.1053/ajot.2001.26499CrossRefGoogle ScholarPubMed
Cassano, M, Di Taranto, F, Russo, GM, De Filippis, C, Cassano, P. Cytological alterations of nasal mucosa after nasal packing. Am J Otolaryngol 2014;35:366–7210.1016/j.amjoto.2013.12.009CrossRefGoogle ScholarPubMed
Wang, J, Cai, C, Wang, S. Merocel versus Nasopore for nasal packing: a meta-analysis of randomized controlled trials. PLoS One 2014;9:e9395910.1371/journal.pone.0093959CrossRefGoogle ScholarPubMed
Akkan, S, Çorbacıoğlu, ŞK, Aytar, H, Emektar, E, Dağar, S, Çevik, Y. Evaluating effectiveness of nasal compression with tranexamic acid compared with simple nasal compression and Merocel packing: a randomized controlled trial. Ann Emerg Med 2019;74:72–810.1016/j.annemergmed.2019.03.030CrossRefGoogle ScholarPubMed
Romano, A, Salzano, G, Dell'Aversana Orabona, G, Cama, A, Petrocelli, M, Piombino, P et al. Comparative study between biodegradable Nasopore (BNP) and Merocel hemox 10 cm after septo-turbinoplasty procedure. Eur Rev Med Pharmacol Sci 2017;21:669–73Google ScholarPubMed
Tan, M, Kalcioglu, MT, Sahin, N, Bayindir, T, Samdanci, E, Filiz, A. Assessment of mucosal changes associated with nasal splint in a rabbit model. Braz J Otorhinolaryngol 2015;81:184–910.1016/j.bjorl.2014.08.004CrossRefGoogle ScholarPubMed
Abu Eta, R, Eviatar, E, Pitaro, J, Gavriel, H. Post-turbinectomy nasal packing with Merocel versus glove finger Merocel: a prospective, randomized, controlled trial. Ear Nose Throat J 2018;97:64–8CrossRefGoogle ScholarPubMed
Weber, RK. Nasal packing and stenting. GMS Curr Top Otorhinolaryngol Head Neck Surg 2009;8:Doc02Google ScholarPubMed
Melis, A, Karligkiotis, A, Bozzo, C, Machouchas, N, Volpi, L, Castiglia, P et al. Comparison of three different polyvinyl alcohol packs following functional endoscopic nasal surgery. Laryngoscope 2015;125:1067–7110.1002/lary.25105CrossRefGoogle ScholarPubMed
Hajiioannou, JK, Bizaki, A, Fragiadakis, G, Bourolias, C, Spanakis, I, Chlouverakis, G et al. Optimal time for nasal packing removal after septoplasty. A comparative study. Rhinology 2007;45:68–71Google ScholarPubMed
Shargorodsky, J, Bleier, BS, Holbrook, EH, Cohen, JM, Busaba, N, Metson, R et al. Outcomes analysis in epistaxis management: development of a therapeutic algorithm. Otolaryngol Head Neck Surg 2013;149:390–8CrossRefGoogle ScholarPubMed
Genç, E, Ergin, NT, Bilezikçi, B. Comparison of suture and nasal packing in rabbit noses. Laryngoscope 2004;114:639–45Google ScholarPubMed
Titiz, A, Zeyrek, T, Ozcan, M, Sabuncuoglu, B, Yilmaz, YF, Unal, A. The effects of Merocel and glove finger tampon applications on the nasal septum mucosa of rabbits. Rhinology 2008;46:112–15Google ScholarPubMed
Maccabee, MS, Trune, DR, Hwang, PH. Effects of topically applied biomaterials on paranasal sinus mucosal healing. Am J Rhinol 2003;17:203–710.1177/194589240301700405CrossRefGoogle ScholarPubMed
Kundi, NA, Raza, M. Duration of nasal packs in the management of epistaxis. J Coll Physicians Surg Pak 2015;25:202–5Google ScholarPubMed
Alshehri, WM, Alwehaibi, WM, Ahmed, MW, Albathi, A, Alqahtani, B. Merocel Surgicel wrap technique to manage diffuse epistaxis in patients with comorbidities. Int J Otolaryngol 2020;2020:827291410.1155/2020/8272914CrossRefGoogle ScholarPubMed