Literature Review: A Roundup of Important Recent Studies

Bottom line: The definition of OSA surgical treatment success is dependent on the PSG scoring system and metrics used.

Citation: Hobson JC, Robinson S, Antic NA, et al. What is “success” following surgery for obstructive sleep apnea? The effect of different polysomnographic scoring systems. Laryngoscope. 2012;122(8):1878-1880.

—Reviewed by Amy E. Hamaker

Intranasal Splint Use after Surgery Increases Patient Pain, Provides Few Offsetting Benefits

Do the benefits of using intranasal splints following nasal septal surgery outweigh the risks?

Background: Intranasal splints are often used following nasal septal surgery for adhesion prevention and septal position support. However, these splints have been shown to cause significant discomfort in patients. Evidence from previous studies on the use of intranasal splints compared with controls and other prevention and support methods may suggest benefits and risks of use.

Study design: Literature review.

Synopsis: Data from six randomized controlled trials (RCT) performed over the previous 20 years that compared outcomes of septal surgery with and without intranasal splints were examined. Three RCTs consisted of patients randomized to receive a splint post-surgery or not to receive a splint. In these trials there was generally little statistical difference in intranasal adhesion prevention, but those patients with splints experienced more post-surgical pain than those who did not have post-surgical splints.

The other three RCTs compared the use of post-surgical splints to a variety of methods. In a comparison of randomized splints and antibiotic meshes versus placement of transseptal horizontal mattress sutures, mucosal adhesion rates and post-operative pain were statistically the same. An RCT of patients undergoing septoplasty alone with a splint inserted on one side only showed no statistical difference in pain between the splint side and control side but better mucosal scores in the splint side. One RCT that used silicone splints with integral airway showed improved mucosal status.

Bottom line: Traditional splints cause a significant increase in pain without sufficient evidence of decreased adhesion prevention; however, newer, thinner splints may offer better treatment options with less pain.

Citation: Tang S, Kacker A. Should intranasal splints be used after nasal septal surgery? Laryngoscope. 2012;122(8):1647-1648.

—Reviewed by Amy E. Hamaker

New Reprocessing Guidelines for ENT Endoscopes Stress High-Level Disinfection Techniques

What are the guidelines for disinfection specific to flexible ear/nose/throat endoscopes?

Background: Endoscopes have become indispensible tools in ENT departments, but poor cleaning and disinfection procedures can lead to patient infections. Although reprocessing guidelines are available for digestive and respiratory endoscopes, specific references to ENT endoscopes do not currently exist. Non-channeled ENT