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1 !"#$%& J J!"#$%%&'()*+,-./01 ERapid RhinoF!!!" #$%Eseptomeatal plastyf!45678!"#$%&' ()*+,-#./ :;<:=>:?@ABCDEF"GHIJ 456)78ERapid - RhinoF!"#$%&'()*+,"!"!"# 40!" #$%#&'()*+,-./01 A B! 20!!"#$%&A!"#$B!"#$%&'()$*+,-./0123^! 24!"#$ %&'%()*+,- 24!"#$%& 48!"#$% _!" 24!"!" 48!"#$%&'() A B!"# Mankoski! EMankoski pain scalef!"#$%&'()*+,-./012/ :;<=>?@#$evisual analog scale, VASF!"#$%&'()*!+,-!"#$%&'()*+%,-./012( :;<=>?@ABCDEFGHIJKL!"#$%&'()EKillian's incisionf!"#$%&'()*+,-./12!"#$%&!"#$%&'()*$+,-./0123(45167()8.'9:;<(=>?!"#$%&'()*"+%,-./01( e!=2004; 16: F!!"#$"%&'()*")+,-)./0-1!"#EÅÜêçåáÅ=ÜóéÉêíêçéÜáÅ=êÜáåáíáëF!Eå~ë~ä=ëÉéí~ä=ÇÉîá~íáçå=F!" #$%!"#$%&'()EêÜáåçã~åçãÉíêóF!"#$%&'()*+,$-./-01!"#$%#&'"()xNz!"#$!"#$%&'()*+,-.&/01!"#$%&'()'*+,-./0 1!"#$%&'()*+,xOz!"#!"#$% &'()*+,-./!"#$%&'()*+,-./0 12!"VO T OP!"#VO U NP!"#VO NM PN!"#$%&'()*+,-. N RT!"#$%!" Tzu Chi Med J No. 3! NST

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4 OK!"#$%&'()*+,- s^p ^! _! m på~åçä=rmm=ãö=l MKQR MKRR mzmksqu héíç MKNR MKQR mzmkmvr! RKRR QKVR mzmknmo!" s^p!"#$ s^p MKVR QKSR mzmkmmm mymkmr!" s^p!"#$%& s^p MKVR SKR mzmkmmm mymkmr ^!"#$_!"#$%&'($) O! _!"#$%&'%()%*!"#$%& '#()*+,-!"# ^!"# téäéêxrz!"#$%&'()*+,-!"#$%&'()*+,-./()*+!"#$%&'()%*+,-.*+/!"#$%&' ()*+,-./01!"#$%&'()*+,-./01$2!"#$%&'( )*+!,-./ EÖ~ìòÉ=ëíêáéF!"#$%&_fmmEÄáëãìíÜ=áçÇçJ Ñçêã=é~ê~ÑÑáå=é~ÅâFqÉäÑ~!"EÑç~ã=é~ÅâáåÖ=F!"#$%EÑáåÖÉêëí~ää=é~ÅâëF!"#$ ) #!"sáöáäçå^äöáå~íé=é~åâ=h~äíçëí~íxsz!"#$ %&'()*+,-./01!"#$%&'()*+,-./012 xnmz!"#$%&'()*+,-./01(!"#$%&'()*+,-&./0!"#$%&'()*é~ê~ññáå!"# é~ê~ññáå=öê~åìäçã~ xnnz!"#$%&'()*+,jj '!"#$%&'()*+,-./012!"#$%&'()*"+,-./012!"#$%&'()*+,-#./012!"#$%&'()*+,-.%/012!"#$%&'() éáäçí=åìññ!"#!"#$%&'()*+,-."#$/0!"#$"%&'()*+,-./$%0 EÅçãéäá~åÅÉF!"#$%&'()%*+!"#$%&'()!*+,-./012!"#$%&'()*+,-. /01!"#$%&'!"#$%&'()*+,"-./& OQ!"#$%&'( NSKMV=ÅãeOl!"#$%&'#()*+,-&'#(. OQ!"#$%&'()*+,-%!./01!"#$%&'()$*+,-$./0!"#$%&'()* +,-#./&0!"#$!"#$%&'()*+, jó~íí jó~íí=xuz!"#$%&'()*+,-./0!"#$%&'()*+,-.#/012!"#$%&'(qu!"#$%&'!"#$%&'()*+,emzmkmqnf OQ!"#$%!&'()*+,-#!"#$%&'()*+,-./01!"#$%&'()*+,-./01!"#$%&'()*+,-./0'!"#$%&j~åâçëâá!"#$%&!"#$%&'()*+'(,-./01!"#$%&'(s^p!"#$%&!"#$%&'()*+,%&-.! NTM! Tzu Chi Med J No. 3

5 !"#$%& J J!"#$%&'U OQ QU j~åâçëâá!"#$%&'()*+,-./!"#$%&'"()*+,- ^ _!"#$%&E m! MF!!"#$%&'()*+,-./!"01!"#$%&'()*+,-./!"# xnoz!"#$%& ëå~åçä âéíç!"!"#$%&'()*+,j~åâçëâá!"#$%&'()*+,-./01-2!"#$ âéíç!"#$%&'()!"#$%&'()*&+,-./012!"#$%&'($)*+,-./01 ^!"#$%!"#$%&'()*+,-./0!"#$EmZMKNMOF!"#$%&'(!"#$%&'()*+,-Eháääá~åDë áååáëáçåf!"#$%&'()*+,-./ (!"!"#$%&'()*"+,-./0!"!#$%&'(#$)*+,-./0!"#$%&'()*!+,-.'/0!"#$%!"#$%&'()*+,-./01!"#$%&'()*+!,#-./0-!"#$%&'()*+#,-./012!"#$%&'()*+, -./012!"#$%&'()*+,-./#012!"#$%&'()*+,$%&-./+!"#$%&'()*+,-".!/! 1. Toppozada H, El-Mansour A, El-Ghazzawi I, Mandour M: Chronic non-allergic hypertrophic rhinitis. A histochemical study. Acta Otolaryngol 1979; 87: Bailey BJ: Nasal obstruction. Head: Neck Surgery - Otolaryngology, 2nd ed. New York: Lippincott-Raven Co, 1998, pp Inouye T, Tanabe T, Nakanoboh M, Ogura M: Laser surgery for allergic and hypertrophic rhinitis. Ann Otol Rhinol Laryngol 1999; 180(Suppl): Talaat M, EL-Sabawy E, Baky FA, Raheem AA: Submucous diathermy of the inferior turbinates in chronic hypertrophic rhinitis. J Laryngol Otol 1987; 101: Weber R, Keerl R, Hochapfel F, Draf W, Toffel PH : Packing in endonasal surger. Am J Otolaryngol 2001; 22: Sirimanna KS: Calcium alginate fibre (Kaltostat 2) for nasal packing after trimming of turbinates - a pilot study. J Laryngol Otol 1989; 103: Mark AY: Women and Pain, New York: Hyperion Press Co, 2002, pp Myatt HM, Myatt RA: The development of paediatric quality of life questionnaire to measure post-operative pain following tonsillectomy. Int J Pediatr Otorhinolaryngol 1998; 44: Hogg RV, Tanis EA: Probability and Statistical Inference 6th ed, New Jersey: Prentice-Hall, 2001, pp Weber R, Hochapfel F, Draf W: Packing and stents in endonasal surgery. Rhinology 2000; 38: Fairbanks DN: Complication of nasal packing. Otolaryngol Head Neck Surg 1986; 3: Uslu SS, Lleri F, Koybasioglu A, Celik H, Sargon M, Ozbilen S: Scanning electron microscopy of hydroxylated polyvinyl acetal and conventional gauze strip nasal packing materials. Am J Rhinol 2001; 15: Tzu Chi Med J No. 3! NTN

6 Another Choice of Nasal Packing for Septomeatal Plasty - Rapid Rhino - Kun-Lin Lee, Chung-Zen Cheng, Chong-Si Lu Department of Otorhinolaryngology, Sin Lau Hospital, Tainan, Taiwan ABSTRACT Objective: Different hospitals use different nasal packing material for controlling postoperative bleeding after septomeatal plasty. Many patients suffer from pain, dizziness, headache, sweating, or severe bleeding when the nasal packing is removed. The purpose of this study was to depict and analyze the advantages and disadvantages of an alternative postoperative nasal packing material - Rapid Rhino. Materials and Methods: We conducted a trial of 40 patients who had chronic hypertrophic rhinitis with nasal septal deviation and who underwent septomeatal plasty. Patients were divided into either group A or B. Group A received Rapid Rhino, while group B received Merocels and vaseline gauze strips as nasal packing material. Air volume and air pressure with Rapid Rhino were recorded in group A patients immediately and 24 hours postoperatively. The packing material was deflated 24 hours after the operation and removed 48 hours postoperatively. Merocels were removed 24 hours and the vaseline gauze strips 48 hours after the operation in group B patients. The Mankoski pain scale and quality of life for group A and B patients were recorded at postoperative 8, 24, and 48 hours. Observations of any feelings of discomfort on a visual analog scale (VAS) were also recorded when removing the Rapid Rhino, Merocels, and vaseline gauze strips. Use of NSAID and gauze by these 2 groups was compared. Results: Patients who used the Rapid Rhino had decreased discomfort and pain when it was removed, as well as reduced consumption of NSAID and improved quality of life during hospitalization. However, its disadvantage included balloon rupture, danger of spontaneous dislocation, as well as easy bleeding at Killian's incision area, which could be controlled with 1 or 2 vaseline gauze strips over the anterior nostril. Conclusions: Rapid Rhino can be easily used postoperatively, and it is more comfortable and less painful and produces less active bleeding when it is removed. Even when bleeding recurred, the cuff can be re-inflated to controlling the bleeding. It is an alternative nasal packing material for nasal operations. (Tzu Chi Med J 2004; 16: ) Key words: chronic hypertrophic rhinitis and nasal septum deviation, Rapid Rhino, Merocel, vaseline gauze strip Received: July 23, 2003, Revised: August 13, 2003, Accepted: October 31, 2003 Address reprint requests and correspondence to: Dr. Kun-Lin Lee, Department of Otorhinolaryngology, Sin Lau Hospital, 57, Section 1, Eastgate Road, Tainan, Taiwan NTO! Tzu Chi Med J No. 3