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. 2025 May 12;87(6):3082-3096.
doi: 10.1097/MS9.0000000000003223. eCollection 2025 Jun.

Risk factors leading to the formation of intranasal synechiae (adhesions) in patients who underwent septo- and septoturbinoplasty (a retrospective cohort Study)

Mateusz J Stępiński  1 , Jacek Banaszewski  2
Affiliations

Risk factors leading to the formation of intranasal synechiae (adhesions) in patients who underwent septo- and septoturbinoplasty (a retrospective cohort Study)

Mateusz J Stępiński et al. Ann Med Surg (Lond). .

Abstract

Introduction: Intranasal adhesions (synechiae) are common complications of nasal surgery. This study aimed to analyze the factors influencing the development of synechiae, with particular emphasis on the use of nasal septal splints. We also propose a solution to reduce the incidence of this complication in the future.

Methodology: This retrospective analysis of patients (n = 243) who underwent septoplasty and septoconchoplasty between 2017 and 2022.

Results: Iatrogenic intranasal synechiae occurred in 26.75% (65/243) of patients. Among patients who received nasal septal splints, synechiae occurred in 13.1%. Synechiae complicated 46.9% of the surgeries in the group without separators (P < 0.001). There was no statistically significant relationship between increased risk of synechiae and concomitant conchoplasty (26% vs. 27.7%, P = 0.817). Patients with seton gauze dressings experienced synechiae significantly more often than those with nasal tampons or other gauze dressings (P < 0.001).

Conclusions: The use of nasal septal separators and tampons significantly reduces the risk of iatrogenic intranasal synechiae following septoplasty or septoconchoplasty, regardless of the degree of nasal septum deviation. Conversely, the use of seton gauze dressings is associated with a higher risk of developing synechiae.

Keywords: nasal septum; nasal surgical procedures; turbinates.

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Conflict of interest statement

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. Nothing to declare.

Figures

Figure 1.
Figure 1.
Details of the selection process.
Figure 2.
Figure 2.
Division of the study and control groups by gender.
Figure 3.
Figure 3.
Characteristics of the study group due to the use of nasal septal separators, simultaneous turbinoplasty and the degree of (preoperative) nasal septal deviation.
Figure 4.
Figure 4.
Characteristics of the control group due to the use of nasal septal separators, simultaneous turbinoplasty and the degree of (preoperative) nasal septal deviation.
Figure 5.
Figure 5.
Residents group, structure of synechiae, and type of dressing.
Figure 6.
Figure 6.
Specialist group, structure of synechiae, and type of dressing.
Figure 7.
Figure 7.
Stages of Cottle’s septoplasty.
See this image and copyright information in PMC

References

    1. Niemczyk K, Jurkiewicz D, Składzień D, et al. Otolaryngologia Kliniczna. Vol 2 ed. Warsaw: Medipage; 2015: 314–16.
    1. Bochenek A, Reicher M. Anatomy of Man Vol 2, 9th edition (reprint). Warsaw: PZWL; 2008: 325–42.
    1. Theissing J, Rettinger G, Werner JA. Otorhinolaryngology. Head and Neck Surgery. Niemczyk K, ed. Warsaw:Medmedia; 2014:49–79.
    1. Watters C, Brar S, Yapa S. Septoplasty 2022 Nov 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024. Jan. PMID: 33620795. - PubMed
    1. Egbert H. Incorrect terminology in nasal anatomy and surgery, suggestions for improvement. Rhinology 2003;41:129–33. - PubMed

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