The effect of septal quilting sutures, nasal packing, and internal nasal splints on outcomes following septoplasty: a comparative prospective study

Background Nasal septal deviation is a highly prevalent condition and represents a major contributor to nasal airway obstruction, with reported occurrence in up to 80% of individuals. Aim To compare the outcomes of septal quilting sutures, nasal packing, and internal nasal splints in septoplasty with respect to postoperative headache, pain, sleep disturbance, bleeding, hematoma, epiphora, synechia, and crusting. Patients and methods This randomized prospective comparative clinical study included 60 patients with symptomatic deviated nasal septum causing persistent nasal obstruction. Patients were recruited from the Otorhinolaryngology Outpatient Clinic, Mansoura University Hospital, between November 2021 and November 2022. Group A underwent septoplasty with septal quilting sutures, Group B underwent septoplasty with bilateral intranasal packing using Merocel, and Group C underwent septoplasty with internal silicone nasal splints. Postoperative outcomes were assessed using the Visual Analogue Scale (VAS) on postoperative days (POD) 2, 7, and 21. Results No significant differences were observed among the three groups regarding age or sex distribution ( P > 0.05). On the 2nd postoperative day, patients who underwent septoplasty with Merocel nasal packing (Group B) reported significantly higher pain, bleeding, headache, epiphora, and sleep disturbance scores compared with those managed with quilting sutures (Group A) or silicone nasal splints (Group C) ( P < 0.001). By the 21st postoperative day, Group B demonstrated the highest incidence of crustation and synechiae, whereas Group A showed the least postoperative morbidity. Conclusion Quilting sutures following septoplasty were associated with significantly lower postoperative pain, bleeding, and nasal complications compared with Merocel nasal packing or silicone splints. This technique offers superior patient comfort and promotes better mucosal healing, making it a preferable alternative to traditional nasal packing methods.