***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: SUMMARY The trans-septal suturing method has been developed in septoplasty as an alternative to packing . This study was carried out to compare the postoperative results of trans-septal suturing with the anterior Merocel packing technique . The study involved 697 patients who underwent septoplasty .  Following surgery , patients were r and omly divided into two groups , one with trans-septal suturing and the other with Merocel packing . Patients were asked to record pain levels using a visual analogue scale . Postoperative symptoms and complications were compared . A total of 697 nasal operations were evaluated in the postoperative period considering pain , bleeding , haematoma , septal perforation synechiae and septal perforation . The results for haemorrhage , haematoma , synechiae and perforation were not statistically different ( p > 0.05 ) between groups . In contrast , the level of postoperative pain in patients undergoing trans-septal suturing was significantly less than in the group who received Merocel packing ( p < 0.05 ) . Patients with Merocel packing had significantly more pain and nasal discomfort when assessed 1 week after intervention . Therefore , the trans-septal suturing technique may be the preferred option to provide higher patient satisfaction Septoplasty is one of the most common otorhinolaryngologic surgical procedure . It is customary to place a pack in the nose as a part of nasal surgery to stop bleeding , enhance apposition of mucosal flaps , and stabilize the operated septal cartilage and bones . But nasal packing is not an innocuous procedure . The most common problem encountered by the patients after septoplasty with nasal pack  is the pain and discomfort in post operative period . The study has been performed to compare the complications and outcome of septoplasty with or without nasal packing .  Forty four patients were r and omly allocated into two groups , Group A ( n = 21 ) and Group B ( n = 23 ) . In Group A trans-septal suture and in Group B intranasal pack was used following septoplasty . Both groups were compared for postoperative pain , postoperative complications and surgical outcome . Among 44 patients 31 patients were male and 13 patients were female . Most of the patients ie 79.5 % were operated for nasal obstruction . Only one patient had postoperative nasal bleeding requiring nasal pack in Group A. Higher Postoperative pain score , longer hospital stay and more complications were observed in Group B patients . No difference was found in patients ' satisfaction after the operation . Septoplasty can be safely performed without postoperative nasal packing and is preferred to avoid postoperative pain , discomfort and other complications The once-common practice of packing the nose  after septoplasty  was based on a desire to prevent postoperative complications such as bleeding , septal hematoma , and adhesion formation . However , it was since found that not only is nasal packing ineffective in this regard , it can actually cause these complications . Although the consensus in the world literature is that packing should be avoided , to the best of our knowledge , no truly r and omized study has been undertaken in Southwest Asia upon which to justify this recommendation here . Therefore , we conducted a prospect i ve r and omized comparison of the incidence of a variety of postoperative signs and symptoms in 88 patients , 15 years of age and older , who did ( n = 44 ) and did not ( n = 44 ) undergo nasal packing following septoplasty .  We found that the patients who underwent packing experienced significantly more postoperative pain , headache , epiphora , dysphagia , and sleep disturbance on the night of surgery . Oral and nasal examinations 7 days postoperatively revealed no significant difference between the two groups in the incidence of bleeding , septal hematoma , adhesion formation , and local infection . Finally , the packing group reported a moderate to high level of pain during removal of the packing . Our findings confirm that nasal packing after septoplasty is not only unnecessary , it is actually a source of patient discomfort and other signs and symptoms Nasal packing may influence the mucociliary clearance of the nose in the postoperative healing phase . In an attempt to overcome some of this problem , a haemostatic septal suturing technique was conceived . In this prospect i ve study , we aim ed to investigate the effects of nasal packing and septal suturing technique on mucociliary clearance by rhinoscintigraphy . Forty-eight adult patients who had undergone septoplasty were included in the investigation . Preoperatively , the patients were allocated into three groups : group 1 , fingerstall packs filled with gauze and smeared with vaseline were used ( 11 male , 4 female ) ; group 2 , silicon septal splint packs were used ( 11 male , 4 female ) ; group 3 , haemostatic septal sutures were used ( 14 male , 4 female ) . Mucociliary clearance was measured by rhinoscintigraphy in all patients before surgery and 6 weeks after surgery . The nasal mucociliary clearance was presented as the velocity ( mm/min ) of nasal mucociliary transport of the 99mTc-MAA droplet . The mean velocity of nasal mucociliary clearances before and after surgery for group 1 , group 2 and group 3 were 1.85 ± 0.67 versus 2.43 ± 0.78 mm/min , 2.36 ± 0.80 versus 2.92 ± 0.96 mm/min and 2.03 ± 0.58 versus 2.62 ± 0.65 mm/min , respectively . A significant difference in nasal mucociliary clearance was observed after surgery in all groups ( p < 0.001 ) . No significant differences were found between the groups regarding mucociliary clearance before and after surgery . Patients with septal deviation have a prolonged mucociliary transit time as compared with postoperative . Nasal packing did not significantly influence the mucociliary clearance in the postoperative healing phase OBJECTIVES This study aims to evaluate the effects of nasal packs on surgical success and related complications in septoplasty . PATIENTS AND METHODS Thirty-eight patients ( 21 males , 17 females ; mean age , 36.6 years , range 18 to 61 years ) were included in the study .  Septoplasty c and i date s were prospect ively divided into two groups . Nasal packing and transseptal suture technique was applied to patients in group 1 ( n=16 ) and group 2 ( n=22 ) , respectively . Postoperative pain was assessed with the visual analog scale . The success of surgery was question ed using the Nasal Obstruction Septoplasty Effectiveness ( NOSE ) scale . Surgical success was defined as a 50 % decrease in the NOSE scores . RESULTS There was no statistically significant difference in surgical success and complication rates between the groups ( p>0.05 ) . Pain scores were significantly higher in group 1 ( p=0.015 ) . CONCLUSION Our study results suggest that nasal pack use does not affect surgical success and complication rates in septoplasty . Pack-free septoplasty with the transseptal suture technique is an effective method in the treatment of septal deviation OBJECTIVE To discuss and compare the results of suturing the nasal septum after septoplasty with the results of nasal packing . METHODS A prospect i ve study , which was performed at Prince Hashem Military Hospital in Zarqa , Jordan and Prince Rashed Military Hospital in Irbid , Jordan between September 2005 and August 2006 included 169 consecutive patients that underwent septoplasty .  The patients were r and omly divided into 2 groups . After completion of surgery , the nasal septum was sutured in the first group while nasal packing was performed in the second group . RESULTS Thirteen patients ( 15.3 % ) in the first group and 11 patients ( 13 % ) in the second group had minor oozing in the first 24 hours , 4 patients ( 4.8 % ) had bleeding after removal of the pack in the second group . Four patients ( 4.8 % ) developed septal hematoma in the second group . Two patients ( 2.4 % ) had septal perforation in the second group . One patient ( 1.1 % ) in the first group , and 5 patients ( 5.9 % ) in the second group had postoperative adhesions . Five patients ( 5.9 % ) were found to have remnant deviated nasal septum in each group . The operating time was 4 minutes longer in the first group . CONCLUSION Septal suturing after septoplasty offers the following advantages : elimination of discomfort for the patients , minimal complications , the outcome is almost the same as with nasal packing , and finally the hospital stay is less than with nasal packing . Therefore , suturing of the nasal septum after septoplasty should be a preferred alternative to nasal packing The need for nasal packing in  septal surgery  is not proven though its use is widespread . Post-operative complications , while uncommon , are frequently pack related . Consenting adults were prospect ively r and omized to one of the following :  Vaseline gauze nasal packing or 30 Dexon mucosal suture .  All patients were operated on by one surgeon who was made aware of the r and omization decision only when the corrective surgery was complete . Details of post-operative morbidity were collected and pain scored subjectively by a visual analogue scale the morning after surgery . The first 50 available pain scales illustrated a difference between the groups ( P less than 0.05 ) , means 4 and 3 in the pack and suture group respectively . There was no demonstrable difference in post-operative haemorrhage , adhesions , nasal crusting or mucosal atrophy . The need for nasal packing is not supported The objective of this study is to compare the nasal packing and the transseptal suturing techniques regarding the extubation difficulty evaluation scores , follow-up times in post-anaesthesia care unit ( PACU ) , pain scores , and postoperative complications .  Two hundred patients who underwent septoplasty from January 2009 to October 2009 were r and omly assigned either to have nasal packs ( n : 100 ) or transeptal sutures ( n : 100 ) . In the transseptal suture group , extubation was easier and PACU follow-up times were shorter , when compared to the nasal packing group ( p < 0.001 ) . Patients with  nasal packing had significantly higher pain scores ( p < 0.001 ) . Minor bleeding was significantly higher in the transseptal group with seven cases , compared to the nasal packing group without any bleeding cases ( p = 0.014 ) . There were two patients who had postoperative major bleeding , and two patients who had septal hematoma in the transseptal suture group . One patient with nasal packing had postoperative infection . Septal perforation was not seen in any of the cases . While patients in both groups experienced postoperative crusting , patients in the transseptal suture group also complained about foreign body sensation . Extubation was more comfortable ; post-anaesthesia monitorization duration was shorter , and postoperative pain was less , but minor bleeding was seen more with transseptal sutures . There was no significant difference in terms of major bleeding , hematoma , infection or perforation . Foreign body sensation was the main cause of postoperative discomfort in the transseptal suture group . Transseptal suturing might be a significantly comfortable , cost-effective and reliable alternative to nasal packing INTRODUCTION Nasal packing is routinely used in septal surgery to prevent postoperative bleeding . OBJECTIVE To demonstrate the possibility of transeptal suture as a safe and effective way to avoid nasal packing and to improve efficiency . METHODS This is a prospect i ve , descriptive , inferential cost study comprising 92 patients . Two r and omized groups of patients were analyzed , one with nasal packing and the other with transeptal suture .  RESULTS In the group of transeptal suture no patient experienced postoperative bleeding , and a statistically significant reduction of pain and headache was demonstrated . At the same time , we improved efficiency by saving on material costs . CONCLUSIONS Transeptal suture is an effective and safe alternative to classic nasal packing in septal surgery . Moreover , it improves the efficiency of the intervention by saving costs OBJECTIVES This study aims to compare pain , bleeding , nasal obstruction , crust and synechia formation , and anesthesia-related morbidity in patients with and without use of nasal packs after septoplasty . PATIENTS AND METHODS A total of 66 patients ( 32 women , 34 men ; mean age 24 years ; range 18 to 48 years ) who underwent Cottle 's septoplasty under general anesthesia  were r and omly allocated to three groups in this prospect i ve cohort . Telfa nasal packs were used in sutures + telfa group ( n=22 ) and Merocell nasal packs in merocel alone group ( n=22 ) . No packs were administered in sutures alone group ( n=22 ) . Three groups were compared in terms of nasal obstruction , bleeding , pain , crust and synechia formation , as well as the amount of secretion , the need for oropharyngeal airway , the presence of laryngospasm , and effort for nasal breathing after anesthesia . RESULTS The amount of bleeding was higher with lower degree of nasal obstruction in sutures alone group . Pain and secretion were more remarkable in merocel alone group . After the first week , these differences were unable to be differentiated among the groups . There were no differences between three groups with respect to crust and synechia formation two weeks after septal surgery . CONCLUSION Nasal packs can be more useful in patients who suffer from bleeding-related morbidity , while sept 
    Output:
    
Meta- analysis showed that postoperative pain , headache , and adhesion were significantly lower in trans-septal suturing group .
Nasal packing and trans-septal suturing technique appear to be equivalent with regard to postoperative bleeding , hematoma , septal perforation , infection , and residual septal deviation .
Trans-septal suturing technology is not only associated with less patient pain , headache , and lower occurrence rate of adhesion after septoplasty but it also relates to higher patient satisfaction and an improved quality of life .
The suturing technology can be used as a substitute for traditional nasal packing of the first-line treatment .