Impact of Early Nasal Splint Removal Following Nasoseptal Flap Harvest on Synechia Formation

Background: Improving quality of life following cranial base surgery has been a driving tenet in optimizing endoscopic endonasal approaches and reconstruction. Following nasoseptal flap harvest and use, silicone splints are typically placed in nasal passages to prevent synechiae formation, which can cause persistent nasal obstruction and limit postoperative nasal debridement. Such splints may be left in place for up to 4 weeks to encompass the remucosalization period for exposed septal cartilage and bone. However, keeping splints in for longer periods may cause patient discomfort and prolonged nasal obstruction. Few studies have attempted to establish the optimal timeframe for splint removal following nasoseptal flap harvest and usage. We hypothesize that removing nasal splints as early as 5 days postoperatively does not increase the risk of synechiae formation.