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" to be packed with one type of packing was done on a mean age was 26.3 years. They were equally distributed
stratified random manner. The patients were numbered as to sex. Basically, all patients underwent operations in
consecutively, and then those who belonged to the odd- the area of the middle meatus plus variations which also
numbered group had their left nasal cavity packed with involved bilateral, symmetrical disruption of nasal tisthe
finger-cot type and their fight nasal cavity with sues (see Table 1). Of the 32 patients, five were not
medium-strip gauze. Those who belonged to the even- anesthesized equally on both sides. On insertion of the
numbered group had their right nasal cavity packed with nasal packs (see Table 2), 15 patients complained of
finger-cot and their left nasal cavity with medium-strip, greater sensation of pain on the medium-strip side and
In each patient, the medium-strip gauze was impreg- only 4 on the finger-cot. The rest claimed that there was
hated with oxytetracycline/polymixin B ointment and no difference. Post-operative bleeding was controlled
the finger-cot externally coated with the same, but the in all patients although 5 patients had minimal transient
medium-strip gauze within the finger-cot extemally posteriorleak from the finger-cotside. Regarding probcoated
with the same, but the medium-strip gauze within lems encountered on insertion of the nasal packs, the
the finger-cot was only dampened with sterile water so surgeons pointed out that extra time was needed for the
as to facilitate packing. (See appendix A.) proper insertion of the finger-cot type in 10 instances.
After the procedure, the patients were sent home At home (see Table 3), 2 patients experienced more
with oral medications consisting of an antibiotic* pain on the medium-strip side. Another 2 patients had
(bacampicinin-PENGLOBE 400 mg BID x 10 days) minimal bleeding leak anteriorly, one for each type of
and analgesic-decongestant (acetaminophen- pheny- packing. Minor complaints like clicking sound on
lpropanolamine 325/18 mg - 650/36 mg TID x 5 days) swallowing and excessive rhinorrhea on the finger-cot
drugs. They were followed up after 3 days for removal side were volunteered by 2 patients respectively. Four
of packs. The finger-cot was first decompressed by patients came back before the scheduled follow-up day
removing the inner dressing from the cot and then re- due to protrusion of the medium-strip gauze into the
moving the cot from the nose. This was followed by oropharynx. The dangling portions were cut transortaking
out the medium-strip gauze as gently as possible, ally, and the patients were sent home subsequently.
Specimens from all nasal packing materials (two from
the finger-cot type--t hat is, one from the outer surface On the 3rd post-operative day, the packs were
and another from the non-medicated inner dressing) removed carefully. Twenty-three (23)patients claimed
were collected and sent to the laboratory for microbiol- that the removal of the medium-strip gauze was more
ogic processing.** painful than that of the finger-cot. Nine (9) felt no
difference between the 2 methods of packing. None
Evaluation of the two methods of packing was singled out the finger-cot as more painful. As to the
conducted through subjective responses from the pa- appearance of the nasal mucosa (see Table 4), there was
tients, objective assessments made by the surgeons, and no portion (i.e., inferior turbinate, septum, middle meatechnical
data provided by microbiologic studies. De- tus and turbinate) in the nasal cavity that was found to
tailed evaluation sheets were provided so as to standard- be abraded in the finger-cot side but smooth in the
ize recording and facilitate analysis of data (see Appen- medium-strip side. Nearly all portions (97% of inferior
dix B). Statistical testing was done using non-par- turbinate, middleturbinate and meatus,72%ofseptum)
ametric methods whenever required, of the nasal cavity on the medium strip side were
abraded. In contrast, to the finger-cot side generally had
smooth mucosa (only 44% of inferior turbinate and 16%
RESULTS
of septum, middle turbinate and meatus were abraded).
Recurrence of bleeding in variable degree was noted in
A total of 32 patients was included in the study with all of the medium-strip side (see Tables 5 and 6). A1-
age distribution ranging from 16 to 40 years old. The though 13 of these cases resolved spontaneously after 5
minutes, 16 required application of 1% ephedrine sul-
....... fate-soaked cotton strips. Repacking of the nasal cavity
* One patient with allergy to ampieillm; erythrornycin S00 TID prescribed was done in half, 13 patients had no recurrence of
instead
bleeding from the finger-cot side. There was no profuse
** Cultar¢ ,,rid identificatio_ were limited lo aerobic microorganisms since rebleeding encountered; all of those that rebled (16
facilities for adequate anaerobic collection were not available, minimal, 2 moderate) resolved spontaneously. On sec-
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