Nasal packing is a temporary medical intervention placed inside the nasal cavity, most commonly used following a severe nosebleed or a surgical procedure. This packing applies pressure or provides a physical scaffold to the internal tissues, supporting the healing process. The material is designed to stay in place for a short period before it is removed or dissolves naturally.
Visualizing Nasal Packing Materials
The appearance of nasal packing varies significantly based on its type and function. Non-dissolvable packing, which requires manual removal, is often a compressed synthetic sponge, such as those made from polyvinyl alcohol (PVA). In its dry state, this material looks like a slender, firm, white or light-colored cylinder. Once inserted and exposed to blood or saline, the material rapidly expands, transforming into a soft, elastic sponge that conforms to the nasal cavity.
Another common type is the inflatable balloon tamponade, which appears as a soft, flexible plastic or silicone catheter. This device often features an external port where air or saline is injected to inflate the internal balloon. Before inflation, the device is slender, but once inflated, the balloon expands inside the nose to exert pressure.
Traditional packing also exists, typically consisting of gauze strips soaked in an ointment or petroleum jelly. This appears as a soft, ribbon-like material that is layered into the nasal passages.
Dissolvable or bioresorbable packing materials have a different appearance since they are designed to break down over time. These often come in the form of gels or soft matrices made from materials like collagen or hyaluronic acid. When placed, they may look like a thick fluid or a soft, sticky material within the nasal cavity. The material slowly disintegrates and is cleared from the nose, often aided by saline rinses.
Why Nasal Packing is Necessary
Nasal packing serves two primary functions: achieving hemostasis and providing internal structural support. Hemostasis refers to stopping active bleeding, which the packing accomplishes by applying consistent, direct pressure to the blood vessels within the nasal passage. By compressing the tissue, the packing encourages the formation of blood clots at the site of hemorrhage. This is particularly important for managing severe or persistent nosebleeds, known as epistaxis.
Structural support is often needed following nasal surgeries such as septoplasty. The packing acts as an internal splint, stabilizing internal structures like the nasal septum and turbinates during the initial healing phase. This support helps ensure that the repaired tissues heal in the correct position. It also helps prevent complications like hematomas, which are collections of blood that can accumulate between tissue layers. The packing promotes a stable environment for wound healing.
The Patient Experience While Packed
The presence of nasal packing leads to a distinct and often uncomfortable sensory experience for the patient. The most noticeable symptom is complete nasal obstruction, which forces the patient to breathe exclusively through their mouth. This mouth breathing often results in dryness in the mouth and throat, sometimes accompanied by a mild headache or feeling of facial pressure. The packing material causes a persistent feeling of fullness inside the nose.
The external appearance of the patient is generally unchanged. However, in some non-dissolvable packing types, the ends of the material may be visible just outside the nostrils, sometimes secured with tape. These packs may also have strings or inflation ports that extend from the nose. Patients may also experience a minor amount of watery, blood-tinged drainage from the nostrils or down the back of the throat. The experience is generally described as a strong sensation of blockage rather than sharp pain, though discomfort can be significant.
What to Expect During Removal
Non-dissolvable nasal packing typically remains in place for 24 to 72 hours, depending on the medical need. The removal process is performed by a healthcare professional using specialized instruments like forceps. Before removal, saline or water is sometimes used to lubricate and soften the material, which helps to minimize trauma to the nasal lining. The process is usually quick, involving the gentle but firm pulling out of the material.
Patients commonly report a sensation of pressure during the removal, rather than intense pain. This is often followed by immediate relief, as the obstruction is cleared and the patient can breathe through the nose again. Minor bleeding or drainage immediately afterward is expected. For patients who received dissolvable packing, no physical removal is necessary, as the material naturally breaks down and is cleared from the nasal cavity over several days to two weeks.