Abstract
In a medical setting, such as the treatment of post-operative nosebleeds, nasal packing, including the use of nasal packs, nasal plugs or nasal tampons (NTs), is widely used to temporarily control anterior epistaxis. Although some literature has documented the use of NTs as a quick, easy and temporary solution to deal with anterior epistaxis in sports-induced nasal injuries, additional research is needed to appreciate on-field versus off-field efficacy, as well as the efficiency of different brands of NTs and packing materials.
Keywords: Feminine hygiene, Nasal packing, Nasal plugs, Otolaryngology, Rhinology
The 2022 men's football FIFA World Cup game between Canada and Croatia caught my attention, not only because of the impressive level of football, but because of the use of a nasal tampon (NT) by the captain of the Canada squad, Atiba Hutchinson, to stop a nosebleed at the beginning of the second half.1
Curious to learn more about the use of this traditionally feminine product to halt or improve epistaxis (nosebleeds or nasal bleeds) in sports, PubMed was initially searched for studies related to NTs (or nasal tamponades) in medicine, discovering 528 and 247 results, respectively. These were manually screened to identify papers that might provide some insight into the medical efficacy and/or limitations associated with NTs, and to identify any papers that recorded the medical efficiency of NTs in sports. No papers that directly used NTs in sports were identified whereas a Google Scholar search for “nasal tampon sports” revealed a few related results, some of which are mentioned next.
Nasal packing using nasal packs or nasal plugs (i.e., NTs) is widely used to control anterior epistaxis, especially in emergency rhinological situations such as post-operative nosebleeds, although the clinical efficacy of NTs can vary depending on the commercial product used, packing material, thickness and other factors.2 The material used can also influence the pain or discomfort during insertion or removal of a NT.3
In sports, an effective NT would likely have the following desirable and practical characteristics in order to achieve hemostasis: 1) it should not easily fall out of the nasal passage; 2) it should absorb blood quickly and efficiently; 3) it should cause minimum pain or distress to the sportsperson during insertion and removal.
Given the widely recorded efficacy of NTs in medical settings, such as postoperative recovery following nasal surgery, including septoplasty,2 their use in sports suggests that they could be a quick and effective method to reduce or halt epistaxis and achieve hemostasis even as a sportsperson is actively moving, i.e., without disrupting the continuation of a game. Evidently, studies involving several sports, and sportspersons with a diversity of cultural and medical backgrounds would need to be assessed in order to gain a better appreciation of the efficacy of this simple medical device for use in a variety of sports. In sports such as soccer, rugby, martial arts, wrestling or boxing, which involve high physicality and blunt body-to-body contact in which nasal injury is possible, even though an NT might temporarily cease epistaxis, other injuries might take place such as nose fractures, which would require other solutions and treatments.4
While assessing the use of NTs in sports as a temporary solution to anterior epistaxis,5 alongside the application of pressure to the nose bridge,6 potential respiratory complications from the use of nasal packing need to be considered,7 as well as the existence of other treatment methods such as transeptal suturing.8
Aesthetically-speaking, it is suggested that the string that is typically attached to one end of the NT, as occurs in vaginal tampons and that is used to remove the tampon/NT, be trimmed so as to reduce its visual association with feminine products, at least in the mind of sports viewers. In a liberal sense, the use of NTs by male players could be seen as a way to democratize the gender debate in sports.
NTs could become a small but important component of sport physicians’ medical bags,9 provided that robust additional research supports their effectiveness in controlling anterior epistaxis on the field or during a sports game. It might also be worthwhile quantifying nasal injuries separate to other head injuries, or to differentiate different types of head injuries, such as in rugby games.10
Submission statement
This manuscript has not been published and is not under consideration for publicaiton elsewhere.
Author's contributions
The author contributed to the intellectual discussion underlying this paper, literature exploration, writing, reviews and editing, and accepts responsibility for the content and interpretations therein.
Conflict of interest
The author declares no conflicts of interest of relevance to this topic.
References
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