Comparison between Rapid Rhino® Pack and Gloved Nasal Pack as Middle Meatal Spacers after Endoscopic Sinus Surgery

Background: Rapid Rhino® nasal pack was used to minimize bleeding and to relieve postoperative pain after endoscopic sinus procedures (ESS), while different nasal packs have been employed in various sinonasal surgeries throughout the last decades. The aim of the study was to compare the effectiveness of Rapid Rhino® Pack and Gloved Nasal Pack as Middle Meatal Spacers after ESS for reducing postoperative adhesion in-patient undergoing ESS and reducing the pain during pack removal.
Patients and Methods: We conducted a prospective, randomized controlled clinical trial, at ENT Department, Faculty of Medicine, at Zagazig University Hospitals on 44 cases. Patients were randomized to receive Rapid Rhino® pack the in one middle meatus (right or left), and the Gloved Nasal pack in the contra-lateral middle meatus intra-operatively.
Results: Sino-nasal Outcome Test (SNOT-22) chart significantly decreased from a pre-operative mean of 52.59 (SD13.17) to 34.18 (SD 8.79) at 3 months post-operatively. Visual Analogue Scale (VAS) for pain significantly decreased in the Rapid Rhino pack groups compared with gloved nasal pack. Bleeding was more in gloved nasal pack side with statistically significant difference among both groups (p=0.007). Endoscopic evaluation of our cases revealed no significant difference between both groups regarding edema, discharge and both groups were significantly improved while significant differences were found regarding while scarring and crusting.
 Conclusion: We concluded that whether packs are always necessary following endoscopic sinus surgery. Rapid Rhino® Pack fulfils their primary purpose of hemostasis and is well tolerated. It has also been shown to cause little pain on removal and may prevent adhesion formation.