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

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.