***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 
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    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 This r and omized study was conducted to evaluate the role of nasal packing  following septorhinoplasty . Fifty septorhinoplasty patients were selected ( on a r and om basis ) to either receive or not receive nasal packing . Twenty-three of 25 patients with nasal packing and 22 of 25 patients without nasal packing were available for follow-up . This study suggests that patients with nasal packing are less likely to develop recurrent septal deviation and synechia and more likely to have improvement in the nasal airway . Only one of the patients with nasal packing found the removal of the packing the most uncomfortable part of the surgery . The most impressive and statistically significant finding , however , was the significant difference between the two groups in terms of airway improvement , which was 96 percent in the nasal packing group and 64 percent in the group without nasal packing . There was also a higher incidence of recurrent or residual septal deviation in the group without nasal packing ( 41 percent ) , while the group with nasal packing had only ( 13 percent ) recurrent or residual deviation OBJECTIVES /HYPOTHESIS 1 ) Study outcomes of revision septoplasty using a vali date d disease-specific question naire and a patient satisfaction survey ; 2 ) assess the effect of surgery on the use of medication to treat nasal congestion ; and 3 ) report on sites of persistent septal deviation identified at revision septoplasty . STUDY DESIGN Prospect i ve , single-center outcome study of patients with symptomatic nasal obstruction and persisting septal deviation despite prior septal surgery . METHODS The Nasal Obstruction Symptom Evaluation ( NOSE ) scale was administered preoperatively and at 3 and 6 months following revision surgery . Patients were also question ed regarding ease of breathing and  medication  use preoperatively and postoperatively , as well as satisfaction with the surgical outcome . Anatomic site(s ) of residual septal deviation were recorded intraoperatively . RESULTS Thirty-nine patients completed the study .  Mean NOSE scores decreased significantly from 75.9 preoperatively to 14.9 3 months after revision surgery . Mean Ease-of-Breathing scores over this interval improved from 3/10 preoperatively to 8.5/10 . Both results were sustained at 6 months ( P < 0.0001 ) . Patient satisfaction was very high , and many patients required less medication to treat symptoms of nasal congestion postoperatively . Deviations persisting from prior surgery most commonly involved the dorsal or caudal septum . CONCLUSION In patients who experience ongoing nasal obstruction with a persistent septal deviation despite prior septoplasty , revision surgery significantly improves disease-specific quality of life , results in high patient satisfaction , and may diminish the need for nasal medications postoperatively . Caudal or dorsal deflections may be more difficult to correct , leading to the need for revision surgery . LEVEL OF EVIDENCE 2C 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 OBJECTIVE The most frequent complaint of patients after septoplasty  is severe pain felt during removal of nasal packing placed on the operation . Various methods have been described to decrease pain and to increase patient comfort during removal of nasal packing . However , these methods are not practical . There has been an increase in the number of studies on pre-emptive analgesia use for postoperative pain relief . The aim of this study was to determine whether pre-emptive analgesia decreased pain during removal of Merocel packs placed in septoplasties . METHODS This is a double-blind r and omized , placebo-controlled study . The study included 121 patients who underwent elective septoplasty in our otorhinolaryngology clinic . The patients were r and omly assigned into two groups : study and placebo groups . The study and placebo groups received two tablets of diflunisal 500 mg and placebo , respectively , two and a half hours before removal of nasal packing . Visual analog scale ( VAS ) values immediately after and 5 min after removal of nasal packing , effects of the procedure on patient comfort and its side-effects were evaluated separately . RESULTS VAS values immediately after the removal of nasal packs significantly decreased in the study group ( p<0.001 ) , but there was no significant difference in VAS values obtained after the procedure between the study and placebo groups . Patient discomforts were significantly lower in the diflunisal group ( p<0.001 ) . CONCLUSIONS It can be concluded that pre-emptive analgesia decreases pain during removal of nasal packing placed in septoplasties and increases patient comfort Background : This study compared the effects of nasal packing and transseptal suturing after septoplasty by evaluating olfactory function , pain , and mucociliary clearance . Methods : The study enrolled 39 patients diagnosed with isolated septal deviation . The patients were r and omly assigned to 2 groups . In Group A ( n = 21 ) , transseptal sutures were placed for septal stabilization after the septoplasty . In Group B ( n = 18 ) , both nasal passages were packed with Merocel tampons after the septoplasty . It was made Sniffin Sticks test , sacchranirine test , and pain and discomfort scales preoperatively , 1 week postoperatively and 3 months postoperatively on all patients . Results : There was no postoperative bleeding , submucoperichondrial haematoma , or abscess formation in either group . The postoperative discomfort and pain scores were increased in Group B ( the packing group ) in our study , the mucociliary clearance improved after septoplasty in both groups , and there was no significant difference in mucociliary clearance between the 2 groups . The odor threshold , odor identification , and odor discrimination were significantly increased 3 months postoperatively , but not 1 week postoperatively . Conclusions : Nasal packing causes more discomfort and pain than transseptal suturing , while there was no significant difference in olfactory functions or the mucociliary clearance after septoplasty between nasal packing and transseptal suturing 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 
    Output:
    
Nonabsorbable nasal packing is no more effective than treatments without packing after septoplasty .
Septal splints and transseptal sutures  reduce postoperative pain , headache , and synechia .