Frequency of Adhesion Formation after Septoplasty Using Nasal Septal Splints

Abstract

Background: Septoplasty is commonly performed to correct a deviated nasal septum and improve nasal breathing. However, postoperative adhesions (nasal synechiae) are a frequent complication that may cause recurrent nasal obstruction. Nasal septal splints are used to prevent adhesion formation, but evidence of their effectiveness in the local population is limited.

Objective: To determine the frequency of postoperative adhesion formation in patients undergoing septoplasty with nasal septal splints.

Methods: This single-arm prospective observational study conducted from 20 November 2025 to 20 February 2026 at the Department of ENT, Pak Emirates Military Hospital Rawalpindi, including 114 patients, having deviated nasal septum with nasal obstruction for more than 4 weeks. All patients underwent septoplasty under local anesthesia and bilateral nasal septal splints were placed at the end of surgery. Data were analyzed using SPSS-30. Association was assessed using Fisher exact test.

Results: Mean age of patients was 39.41±12.04 years and mean body mass index (BMI) was 27.32±2.84 kg/m². Majority of patients were males 80(70.2%). Among 114 patients who underwent septoplasty with nasal septal splints, postoperative adhesions were absent in 107(93.9%) patients, whereas 7(6.1%) patients developed adhesions. Postoperative adhesion formation showed a statistically significant association with gender (p=0.024), while no significant association was observed with age, BMI, socioeconomic status, or residential status (p>0.05).

Conclusion: A low frequency of postoperative adhesion formation was observed in patients undergoing septoplasty with nasal septal splints. Further comparative studies are recommended to evaluate their effectiveness against non-splint management.