title: Septal stapler use during septum surgery.
abstract: Although discussions regarding nasal packing are still ongoing, to eliminate any possible complications, surgeons have used nasal packing for many years. Septoplasty is one of the most frequently performed operations by head and neck surgeons. Any methods to diminish the surgical time or bring comfort to the surgeon will be well appreciated. In this study, we attempted to demonstrate the usefulness of the stapler method by comparing preoperative and postoperative results from the visual analog scale (VAS), nasal obstruction symptom evaluation (NOSE), rhinosinusitis quality of life questionnaire (RQLQ), and acoustic rhinomanometry values. In addition, we evaluated pain scores, postoperative complications, and breathing after nasal packing, stapling, and trans-septal suturing techniques. Patients were divided into three groups. In the first group, deviated cartilage was removed or repositioned and mucoperichondrial flaps were closed with a bioresorbable stapler after septoplasty. Four or five staples were placed on the septum. In the second group, the septum was sutured continuously with 4/0 Pegelak (Doğsan TR). In the third group, Merocel packs were used without any sutures and were kept for 48 h. Nasal packing leads to patient discomfort after septal surgery; however, there is no difference in patient comfort between closing the mucoperichondrial flaps by suturing the septum or using a stapler. After surgery, there were no differences between the groups in terms of successful breathing. This situation was assessed by endoscopic examination and acoustic rhinomanometry. Thus, there was no objective or subjective difference. Stapling increases the doctor's comfort level and surgical time is optimized. Although experienced surgeons can easily suture the septum, less experienced ones have some difficulty; therefore, stapling may provide more benefit to the latter. Further, four staples are sufficient to close the septum.
authors.affiliation: Okmeydani Education and Research Hospital, Istanbul, Turkey.
authors.forename: Güven
authors.initials: G
authors.lastname: Yildirim
authors.forename: Cemal
authors.initials: C
authors.lastname: Cingi
authors.forename: Ercan
authors.initials: E
authors.lastname: Kaya
mesh_terms: D000328:Adult; D001458:Bandages / Q000009:adverse effects; D006801:Humans; D008297:Male; D009300:Nasal Septum / Q000601:surgery*; D009668:Nose Diseases / Q000601:surgery*; D061646:Operative Time; D010149:Postoperative Pain / Q000209:etiology*; D019106:Postoperative Hemorrhage / Q000209:etiology*; D011446:Prospective Studies; D012225:Rhinoplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D013528:Surgical Staplers / Q000009:adverse effects; D013536:Suture Techniques; D016896:Treatment Outcome; D055815:Young Adult