THE EFFECT OF A NEW INTRANASAL SPLINT WITH A CENTRAL AIRWAY ON C-REACTIVE PROTEIN DYNAMICS IN THE POSTOPERATIVE PERIOD FOLLOWING NASAL SEPTUM SURGERY

 In the postoperative period following surgical procedures for a deviated nasal septum, the choice of intranasal support devices directly affects the patient's breathing, comfort, the course of local inflammation, and the speed of recovery. In recent years, there has been a growing trend to abandon complete nasal tamponade in septoplasty and related procedures, instead opting for silicone septal splints, transseptal sutures, or soft support devices with an airway. In a 2021 meta-analysis, Kim et al. showed that using septal splints reduces the incidence of synechiae without increasing rates of pain, bleeding, hematoma, infection, or perforation. In a 2021 systematic review covering a total of 4,087 participants, Titirungruang and co-authors noted that conventional tamponade more frequently causes adverse events such as respiratory distress, pain, sleep disturbances, crust formation, and adhesions. In their 2023 review, Ivanova and Iliev stated that silicone splints and transseptal sutures can often be a suitable alternative to traditional tamponade after septoplasty and rhinoseptoplasty.

At the same time, the design features of the intranasal device are also important. Splints with an airway allow the patient to retain some ability to breathe through the nose, even in the early stages. This reduces the discomfort associated with mouth breathing, improves sleep quality, and lessens psychoemotional stress. In 2017, Bingol et al. showed that intranasal splints with an airway significantly reduced nasal congestion, difficulty eating, nighttime discomfort, and pain during removal compared to the Merocel tampon. In 2023, Jamil et al. noted that using an intranasal material with an airway leads to decreased postoperative pain and better preservation of oxygen saturation. Thus, the main criterion in developing new-generation splints remains not only supporting the septum, but also facilitating the patient's recovery process.

This thesis evaluates the clinical significance of a new intranasal splint with a central airway, based on the dynamics of C-reactive protein. C-reactive protein is an acute-phase indicator that rises in response to surgical trauma, and its rise and fall trajectory is considered an objective laboratory criterion for the recovery process. In modern observations, it has been noted that after uncomplicated surgeries, C-reactive protein typically peaks on days 2-3 and decreases in the following days; this trend may slow down or be replaced by a secondary rise when complications occur. Therefore, C-reactive protein levels on the 1st, 5th, and 10th days reflect not only the intensity of the inflammation but also the rate of its resolution.