Trans-septal suturing technique in septoplasty: a systematic review and meta-analysis.
BACKGROUND
Trans-septal suturing techniques are routinely used to obviate the need for packing after septoplasty surgery. This study aimed to systematically assess the evidence for the efficacy and safety of suturing techniques after septoplasty.


METHODS
A MEDLINE, Scopus, Cochrane Library, and ProQuest Dissertations & Thesis Database search, followed by extensive hand-searching for the identification of relevant studies. No time and language limitations were applied. Only prospective randomized controlled trials (RCTs) comparing trans-septal suturing techniques following septoplasty with conventional packing were included. For each outcome, risk difference and 95% confidence intervals (CIs) were calculated. Tests for heterogeneity and tests for publication bias were applied.


RESULTS
Eight RCTs with 869 patients were included in the review. Postoperative pain and headache were significantly lower in the non-packing group. Conventional packing and trans-septal suturing technique appear to be equivalent with regard to postoperative haemorrhage risk, mucosal adhesions, septal perforation, septal haematoma and local infection.


CONCLUSIONS
The evidence for the advantage of suturing techniques over conventional packing in septoplasty is now robust, and the use of suturing techniques as a first line intervention is becoming advisable.
Department of Otorhinolaryngology, Hospital Sao Sebastiao, Portugal. victorcertal@gmail.com
V
V
Certal
H
H
Silva
T
T
Santos
A
A
Correia
C
C
Carvalho
D006801:Humans; D009300:Nasal Septum / Q000601:surgery*; D012225:Rhinoplasty; D013536:Suture Techniques; D016896:Treatment Outcome