• A S Cruise, K Amonoo-Kuofi, I Srouji, J Kanagalingam, C Georgalas, N N Patel, L Badia, and V J Lund.
• Department of Rhinology Research Group, Royal National Throat, Nose and Ear Hospital, London, UK. mr.andrew.cruise@gmail.com
• Clin Otolaryngol. 2006 Feb 1; 31 (1): 25-32.

ObjectivesTo compare Telfa with the Rapid Rhino Riemann nasal pack for use following endoscopic sinus surgery.DesignProspective, randomized, double-blind, paired trial.SettingTertiary otolaryngology hospital.ParticipantsForty-five adult patients undergoing bilateral endoscopic sinus surgery for either chronic rhinosinusitis or nasal polyps.Main Outcome MeasuresA visual analogue scale was used to assess discomfort caused by the presence of the packs in the nose and by their removal. The amount of bleeding was noted with the packs in place and following their removal. Crusting and adhesions were assessed 2 and 6 weeks following surgery.ResultsBoth packs performed well giving good haemostasis and causing little bleeding on removal. Both packs caused only mild discomfort while in the nose. On the visual analogue scale of 0-10 cm the mean visual analogue score for Rapid Rhino Riemann pack was 1.7 and for Telfa 2.0 (P = 0.371). The Rapid Rhino Riemann pack caused significantly less pain on removal compared with the Telfa pack with a mean visual analogue score of 2.0 in comparison with 3.7 for Telfa (P = 0.001). There were less adhesions with the Rapid Rhino Riemann than Telfa pack but this was not statistically significant (P = 0.102).ConclusionsBoth Telfa and Rapid Rhino Riemann packs can be recommended as packs that control postoperative haemorrhage, do not cause bleeding on removal and cause little discomfort while in the nose. The Rapid Rhino Riemann pack has the advantage of causing significantly less pain on removal.

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