Septal Suture Research Articles

First occurrence of the rare middle Jurassic ammonite genus Erymnocerites Jeannet from southern Poland

ABSTRACT The genus Erymnocerites Jeannet is recorded for the first time from Poland. A single specimen, assigned to Erymnocerites argoviensis Jeannet is recorded from the Callovian Lamberti Zone from the Ogrodzieniec quarry (southern Poland). It is associated with upper Callovian forms of Peltoceras schroederi, Kosmoceras duncani and Quenstedtoceras lamberti. However, this condensed bed also yielded lowermost Oxfordian species of Peltoceratoides (Peltoceratoides) williamsoni, Peltoceratoides (Parawedekindia) arduennensis, Euaspidoceras subbabeanum, E. babeanum, Bukowskites minax, Cardioceras spp. and Hecticoceras (Putealiceras) punctatum, suggesting a condensation spanning the uppermost Callovian to lowermost Oxfordian for the lower beds at the Ogrodzieniec quarry. The recorded specimen differs from the middle Callovian Coronatum Zone E. argoviensis, which is a much larger (still septate at 188 mm), more depressed, less evolute, and has a rounded whorl section. However, based on the similarities in septal suture line and ribbing pattern, and considering the morphological variations in pachyceratids, the Polish specimen is referred to E. argoviensis. Based on the size difference between the Herznach (Switzerland) holotype of E. argoviensis (phragmocone~188 mm; maximum shell diameter~320 mm) and the Polish specimen (phragmocone 76 mm; maximum shell diameter 133 mm), it is speculated and the latter be the corresponding microconch.

Septoplasty with Nasal Packing or Transseptal Suturing: comparative study

Objective: The aim of study is to find out the better option to manage post-operative septal hematoma between the nasal packing or quilting sutures.
 Methods: cross sectional comparative study of 2 groups patients, group [A]; 39 patients have septoplasty with no nasal Packing and suturing, while group [B]; 40 patients have septoplasty with nasal packing. The study has been carried out from July 2021 until February 2022 in Kirkuk General Hospital. From all patients take age, gender, pain, and bleeding occurrence after few moments after surgery, then after 1st day and then after seventh day after operation. Also, if patients have synechiae or not.
 Results: there is significant difference between group A and group B in bleeding at time of operation, group A patient more bleeding. There is significant difference between group A and group B in bleeding at 1st day after operation, group A patient less bleeding. There is significant difference between group A and group B in pain at 1st day after operation, group A patient less bleeding. There is significant difference between group A and group B in pain at 7th day after operation, group A patient less bleeding.
 Conclusion: Nasal pain, headache, were reduced in the trans – septal suturing group as compared to packing. However, nasal bleeding was present in both the groups. It also proves to be a cost-effective modality and gives a better post-operative quality of life to patients. Hence, we recommend trans-septal suturing as the preferred method over anterior nasal packing in patients after septoplasty.

Composite reconstruction of right ventricle and tricuspid valve for cardiac angiosarcoma

Composite reconstruction of right ventricle and tricuspid valve for cardiac angiosarcoma

Role of cartilage correcting sutures in single-stage secondary rhinoplasty for unilateral cleft lip nose deformity.

Introduction:The purpose of this study is to highlight the role of cartilage correcting suture in single-stage surgical correction for secondary unilateral cleft lip nose deformity with three-dimensional observations of preoperative and postoperative nasal forms.Material and Methods:Between July 2017 and June 2019, 18 consecutive patients of unilateral cleft lip nose deformity aged between 16 and 28 years underwent surgical correction. The corrective procedure of nose involved columellar lengthening, medial and lateral nasal osteotomies along with augmentation of premaxilla by bone graft at premaxilla, and alar base wedge resections. Focus was laid to correct nasal cartilaginous framework using tip sutures along with repositioning of lower lateral cartilages, fixation of the alar cartilage complex to the septum, and the upper lateral cartilages. We investigated the following surgical interventions and nasal tip suture techniques, which were transdomal suture, interdomal suture, lateral crural mattress suture, columella septal suture, and intercrural suture.Results:We achieved adequate esthetic and functional results in all the patients without any morbidity.Conclusion:This concept of simultaneous approach toward complete single-stage correction of secondary cleft lip nasal deformity incorporating various cartilage suture using 5-0 nylon in developing nation like ours, where the patient presents late with complex conditions showed promising esthetic and functional outcome.

Management of Iatrogenic VSD during Systemic RVAD Implantation: Case Report

<h3>Introduction</h3> This is a case of a 16-year-old male with ccTGA who underwent systemic RVAD (HeartMate III) implantation for severe systemic RV dysfunction. <h3>Case Report</h3> Based on suboptimal transesophageal (TEE) and epicardial ECHO imaging, the inflow cannula was to be placed anterior and lateral to the true apex of the systemic RV. The ventriculotomy created by a coring device overrode into the ventricular septum and was hidden underneath the inflow cannula ring (<b>Fig 1A</b>). After VAD support was initiated, patient became severely hypoxic with a PO₂ of 45-50 mmHg. CPB was re-initiated and the inflow cannula was removed, revealing a large iatrogenic VSD at the cannula insertion point. VSD was closed by bovine pericardial patch and the ventriculotomy was extended laterally to relocate the VAD sewing ring (<b>Fig 1B</b>). After CPB was weaned again, patient initially remained cyanotic and imaging identified possible tiny VSD patch leak with right to left shunting as a potential cause of hypoxia. Pursuing residual VSD closure was deemed unsafe. Rescue nitric oxide (NO) infusion dramatically corrected the desaturation. <h3>Summary</h3> Iatrogenic VSD in the setting of systemic RVAD causes significant hypoxia but can be effectively repaired by patch closure. Determining the favourable positioning of the inflow cannula in ccTGA is a technical challenge. Using a combination of TEE and epicardial ECHO offers superior guidance for cannula insertion, but can still be inadequate in preventing iatrogenic injury. Furthermore, even small residual VSDs or septal suture holes can be a source of hemodynamically significant right to left shunting due to the high negative pressure from the inflow cannula. In these situations, medical optimization may be the solution. Rationale for the remarkable effect of NO in our case is somewhat unclear, but perhaps explained by improved ventricular ejection and decompression from the subpulmonary LV. <b>Figure 1.</b> ECHO of <b>A)</b> iatrogenic VSD hidden by sewing ring and <b>B)</b> RV after VSD patch closure and lateral repositioning of inflow cannula.=

Optimal harvest and efficient use of septal cartilage in rhinoplasty.

BackgroundNasal septal cartilage is used to obtain favorable aesthetic and functional outcomes in rhinoplasty, but is often difficult to harvest or the harvested amount is insufficient. Therefore, the objective of this study is to introduce how to harvest septal cartilage optimally without losing and use harvested cartilage efficiently.MethodsFrom March 2015 to January 2020, we tried to harvest as much septal cartilage as possible while maintaining the L-strut in 30 patients. A spreader flap and septal rotation suture were used instead of a spreader graft. Also in patients who needed a spreader graft and septal extension graft, a spreader graft was used on one side and a one-piece spreader graft combined with a septal extension graft was performed on the other side. For tip plasty, a columella septal suture was performed first. Postoperative patient satisfaction was assessed using the Rhinoplasty Outcome Examination questionnaire.ResultsNo serious complications were observed. The patient satisfaction score was 50% or above in 27 patients (90%) and less than 50% in only three patients (10%). The average score was 81.5 points.ConclusionFor septal cartilage deficiency, a spreader flap, the septal rotation suture, or one-piece spreader graft combined with a septal extension graft was used. The nasal tip was sufficiently rotated using the columellar septal suture technique first. These techniques made it possible to obtain good aesthetic outcomes using only septal cartilage, without harvesting other cartilage.

Is nasal septal suturing an alternative technique to nasal packing?: A protocol for systematic review and meta-analysis.

Background:Nasal septal suturing is a commonly used alternative treatment to nasal packing after septoplasty. Besides alleviating postoperative discomfort, extensive studies have shown that nasal septal suturing is more effective than nasal packing. However, its clinical benefits remain controversial.Methods:We will perform a systematic review of nasal packings effect-related outcome in comparison to nasal septum suture among septoplasty patients by searching 8 databases, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). All eligible studies will be screened against the inclusion and exclusion criteria. Two independent reviewers will extract the data. Moreover, Review Manage 5.3 will be used for quality assessment and data analysis. Then, the random effects model or fixed effects model will be applied according to the heterogeneity. In conformity with the GRADE criteria, the merits of the evidence and recommended strength will be assessed.Results:This protocol will guide subsequent systematic reviews and meta-analyses. The differences in efficacy between nasal septal suturing and nasal packing after septoplasty will be evaluated in terms of efficiency, adverse reaction, comfort degree, and other factors.Conclusion:This proposed study will explore the possibility of adopting nasal septal suturing as an alternative to nasal packing after septoplasty.OSF registration number:doi: 10.17605/OSF.IO/WF3GX.

Trans-septal Suturing Versus Merocel Nasal Packing: A Post Septoplasty Comparison.

It has been observed that nasal packing following septoplasty contributes to co-morbidities like post-operative pain, bleeding and increased duration of hospital stay. Trans-septal suturing has been suggested as a safe and effective alternative with a view to obviate the need for nasal packing and the hence avoid the discomfort associated with it. To compare the outcome of trans-septal suturing technique with merocel nasal packing after septoplasty. This was a prospective comparative study done on 60 patients who underwent septoplasty. The patients were divided randomly into 2 groups, while Group A comprised of patients undergoing Post-operative nasal packing with poly vinyl alcohol sponge (also commercially called Merocel), Group B included patients who underwent nasal septal suturing after surgery. The postoperative pain, hemorrhage and duration of hospital stay were the main parameters that were assessed and a comparison was drawn between the post-operative outcome of two techniques. Post-operative global pain score was 62.18 ± 4.75 in the group A (patients with nasal packing) and 24.73 ± 4.29 (patients with trans-septal suturing) in group B ('p'value was < 0.0001). Post-operative bleeding was noticed in 19 patients (out of 30) in group A, and in 2 patients of group B ('p'value was < 0.0001). 27 out of 30 patients of Group A were discharged on day 2 whereas 24 out of 30 patients of Group B required only 1day of hospital stay after the surgery ('p' value was < 0.0001). Trans-septal suturing technique reduces the duration of hospital stay, causes lesser post-operative bleeding and pain and is a relatively less painful technique than merocel nasal packing.

Morphological peculiarities of fruits of the rare species Iris halophila Pall, I. pumila L. and I. hungarica Waldst. et Kit. (Iridaceae Juss.) in the conditions of introduction in the meadow-steppe cultural phytocenosis

Objective – to analyze morphological structure and to reveal common and distinguishing features of the fruit in rare steppe species Iris halophila, I. pumila and I. hungarica introduced in conditions of meadow-steppe cultural phytocenosis in the M.M. Gryshko National Botanical Garden NAS of Ukraine (NBG).&#x0D; Material and methods. Fruits of I. halophila, I. pumila and I. hungarica were collected on the botanical-geographical plot “Steppes of Ukraine” of NBG during 2015–2019. Morphological terms are provided according to Artyushenko &amp; Fedorov (1986).&#x0D; Results. In all analyzed species, fruit is a trimeric and trilocular loculicidal capsule with multi-seeded locules. This capsule is erect, straight, leathery, glabrous, opening by dehiscence from top to bottom along the dorsal veins of carpels. The morphological peculiarities of the fruits, which may be additional diagnostic characters of these species, are established. In particular, in I. halophila capsule is cylindrical with the upper part elongated into the apical spout (long, thin, bent to the side). The surface of I. halophila capsule is smooth, matte, six-ribbed. Ribs are located on both sides along each of dorsal veins (i.e., along the dehiscence stria). The dehiscence is complete with diverging upper parts of the valves that remain connected just at the base. Capsule of I. pumila is ellipsoidal with the upper part also elongated into the apical spout (short, thick, awl-shaped). The surface of I. pumila capsule is wrinkled, without ribs. Commissural (septal) suture and dorsal veins are protruding. The capsule dehisces completely by three slits, but the valves remain connected in the apical part and at the base. Capsule of I. hungarica is oblong-ellipsoidal, without apical spout. The surface is veined, grumous, with six grooves above the commissural sutures and dorsal veins, without ribs. The capsule of I. hungarica opens only partly toward the peduncle, leaving lower part indehiscent. The upper parts of the valves diverge, while the lower part of capsule remains unopened.&#x0D; Conclusions. It was established that shape of capsule, in particular structure of its upper part, presence of ribs and apical spout, as well as the surface features together with peculiarities of dehiscence are constant parameters and can be used as diagnostic characters to distinguish these species. The size and color of the capsules, as well as the number of seeds per capsule of I. halophila, I. pumila and I. hungarica varied – this may depend on environmental conditions, in particular geographical location, and many other factors, which should be analyzed precisely in future.

Application of continuous suture of inferior turbinate in surgery for chronic hypertrophic rhinitis with or without nasal septum deviation.

To explore the application value of continuous suture of the inferior turbinate in inferior turbinate submucosal bone resection. Twenty patients with chronic hypertrophic rhinitis with or without nasal septum deviation underwent inferior turbinate submucosal bone resection with or without septoplasty. The inferior turbinate was continuously sutured with or without nasal septum suture after surgery. The nasal cavity was not packed. The postoperative clinical outcome was evaluated using visual analog scales (VASs), saccharin test, nasal endoscopy, and nasal resistance test. Postoperative complications were recorded. All 20 endoscopic surgeries were successfully performed. One day after surgery, the VAS scores of nasal pain (1.3 ± 0.5), headache (0.8 ± 0.4), tearing (0.3 ± 0.3), and bleeding (0.3 ± 0.3) in patients were low; 1week after surgery, the nasal mucociliary transport time was not significantly prolonged compared to that before surgery (P > 0.05); 1month after surgery, the symptoms of nasal congestion had improved significantly, as the VAS score for nasal congestion was lower than that before surgery (P < 0.05); the volume of the hypertrophied inferior turbinate of all patients was reduced, the mucous membrane was smooth and rosy, the nasal septum was centrally located, and the total nasal resistance values at 150Pa pressure had returned to the normal reference range (0.282 ± 0.103Pa/cm3/s); no complications such as bleeding, nasal infection, nasal dryness, and olfactory disorders occurred. After inferior turbinate submucosal bone resection with or without septoplasty, inferior turbinate continuous suture with or without nasal septum suture instead of nasal packing can significantly improve postoperative discomfort, improve nasal ventilation, protect nasal function, and accelerate postoperative recovery.

Endoscopic Septoplasty without Nasal Packing: An Experience in a Tertiary Hospital

Background: Deviated nasal septum (DNS) is easily caused by trauma and septal surgeries have evolved from forceful fractures to endoscopic surgery being the leading trend now. Endoscopic surgery has lots of advantage over the conventional headlight method in alleviating symptoms and reducing complications. Endoscopic septoplasty without the nasal packing significantly shorten the surgery time and hospital stay thus reducing the financial burden. Hence this prospective study done in Nobel Hospital and Teaching Center was an Endeavour to see the indications, technique and outcome of the new surgical procedure.&#x0D; Materials and Methods: Sixty-five patients irrespective of sex in the age group of 18-60 years were enrolled in the study from December 2017 to December 2018. All symptomatic DNS confirmed by 00 and 300 rigid endoscope were enrolled. Informed consent from patients and ethical clearance was taken.&#x0D; Results: The maximum patients were in the age group of 18-30 years. The commonest symptoms of the patient was nasal obstruction in 51(78.46%), followed by post-nasal drip in 20(30.76%), hyposmia in 17(26.15%), headache in 15(23.07%) and epitasis in 10(15.38%). According to Mladina classification, the commonest deviated septum was type V in 29(45%), followed by type VI in12(18%), type II and IV in 7(11%) each, type VII in 6(9%) and least being type III in 4(6%) patients. There were no patients with Mladina type I DNS in this study. The improvement in symptoms were 90% in nasal obstruction, 88% in hyposmia, 85% in post nasal drip, 90% inepistaxis and 100% in headache. The complications were haemorrhage in 1(1.5%), synechia2(3.07%), mucosal tear 5(7.69%), haematoma 1(1.5%) and persistant DNS 5(7.69%). The average hospital stay was 48 hours.&#x0D; Conclusion: Endoscopic septoplasty without post-operative packing is very convenient to the patient. Endoscopic septoplasty with trans- septal suture is safe, cost effective and a better alternative.

Comparison results of nasal septum suturing and nasal packing following septoplasty

Abstract BACKGROUND. Septoplasty is routinely used to resolve the deviated nasal septum. To obviate postoperative complications, some surgeons pack both nasal cavities and some other use suturing techniques after septoplasty. OBJECTIVE. To investigate the efficacy of septal suturing and packing in patients post-septoplasty. MATERIAL AND METHODS. This study was conducted in the Department of Otorhinolaryngology, Loghman Hakim, Tehran, Iran. 146 patients aged 17 years and above were enrolled for septoplasty. Septal suture was performed in 73 patients (group A) and nasal packing in the other 73 patients (group B). The principal outcomes in terms of bleeding, pain, respiratory problems, septal hematoma, adhesion and perforation were measured over a post-operative follow-up period. RESULTS. A total of 146 patients, 74% female and 26% male, were enrolled. There were statistically significant differences between the two groups with respect to respiratory problems and patient comfort (p&lt;0.001). The patients in both groups had no septal perforation. CONCLUSION. Septoplasty using trans-septal suturing without packing can be safe and suitable to prevent or minimize postoperative complications.

Pseudoinversion of septal sutures in Middle Jurassic–Lower Cretaceous non-heteromorph ammonites

New records of ammonites showing poorly known sutural anomaly, so-called sutural pseudoinversion, are discussed. For the first time, sutural pseudoinversion was found in non-heteromorph Jurassic and Lower Cretaceous ammonoids, which are belonging to 10 genera (Dorsetensia, Indosphinctes, Erymnoceras, Pictonia, Aspidoceras, Kachpurites, Craspedites, Delphinites, Nikitinoceras and Immunitoceras) and 8 families (Sonniniidae, Pseudoperisphinctidae, Pachyceratidae, Aulacostephanidae, Aspidoceratidae, Craspeditidae, Neocomitidae and Parahoplitidae). Two types of sutural pseudoinversion were recognized: normal sutural pseudoinversion, in which the outline of small elements in lobes and saddles is fully reversed, and transitional sutural pseudoinversion, characterized by changes in the outline of folioles only. Usually, sutural pseudoinversion occurs in the terminal part of the phragmocone and becomes especially clear on the last sutures near the body chamber, but in some studied specimens sutural pseudoinversion appears in middle whorls and can be traced further up to the last visible sutures. Sutural pseudoinversion could not be caused by mechanical compression of saddles due to sutural asymmetry or strong development of sculptural elements as Bayer (Lethaia 11:307–313, 1978) assumed. Pseudoinversion is usually (although not always) visible in all sutural elements. Although pseudoinversion is known in those taxa with strong sutural asymmetry, pseudoinversion and asymmetry often affected different specimens. Influence of hydrostatic overpressure during the septal formation as well as parasite infestation on development of sutural pseudoinversion is considered to be unlikely. Instead, an abnormality appears to be a case of homeotic mutation, possibly caused by transcription errors in polarity genes. Much more common occurrence of sutural pseudoinversion in ammonites than it was expected previously suggest that it could be a relatively common phenomenon that needs increased attention in the future.

Nasal Septal Suture Technique versus Nasal Packing after Septoplasty: A Prospective Comparative Study

Nasal Septal Suture Technique versus Nasal Packing after Septoplasty: A Prospective Comparative Study

Correlation of Age Related Changes of Nasal Tip Support Mechanisms with Anthropometric Measurements

Background: age-related changes of the face have been an area of intense interest and the focus of considerable researches. The facial skeleton and overlying soft tissue undergo a gradual transformation throughout the aging process and there are several consistent age-associated changes of the nose. Aim of the Work: this study aimed to evaluate the age related cellular and architectural changes of nasal tip support mechanisms, in correlation to its anthropometric measurements. Patients and Methods: this prospective study was conducted in Plastic and Reconstructive Surgery and Histology Departments, Ain-Shams University Hospitals, Cairo, Egypt. Forty-five patients were included in this study. They had undergone aesthetic rhinoplasty operations, 10 males (25%) and 30 females (75%) with mean age 35.42±15.15 years and age range 19–60 years. Results: LLC is the most nasal tip support mechanism affected by aging as every 1 year increase in age; correspond to weakness in LLC by percent -1.077followed by ULC, SC, SCA, IDA, ICA, NLA, and projection respectively (P value <0.001). Conclusion: aging patients present unique technical challenges in rhinoplasty that warrant a comprehensive approach to restore and preserve tip support. Recommendations: medial crural septal suture should be performed in all elderly patients undergoing aesthetic rhinoplasty, both to prevent further exaggeration of the already existed acute nasolabial angle and to maintain the nasal tip projection and rotation.

Feasibility of single-staged Han-uvulopalatopharyngoplasty with septoplasty in adults with obstructive sleep apnea-hypopnea syndrome

Objective: To explore the feasibility and therapeutic effect of single-staged Han-uvulopalatopharyngoplasty with septoplasty in adults with obstructive sleep apnea-hypopnea syndrome. Methods: Ninety six cases with OSAHS were diagnosed by polysomnography, and they all had retropalatal obstruction and deviation of nasal septum. Patients were divided into study group(48 cases) and control group(48 cases) randomly. Cases in study group were simultaneously treated with Han-uvulopalatopharyngoplasty and septoplasty, while cases in control group were only treated with Han-uvulopalatopharyngoplasty. U saturation skill and coblation-assisted were applied in Han-uvulopalatopharyngoplasty. And nasal septum suture technique was applied in septoplasty. The observation index included the intranasal changes with acoustic rhinometry, the prevalence of common postoperation complications and curative effects after six months follow-up period. SPSS 18.0 was used for statistical analysis. Results: In study group the overall response rate was 83.33%(40/48), while in control group the overall response rate was 62.50%(30/48). There was statistical significance of response rate between test group and control group(χ(2)=5.275, P<0.05). There was no statistical significance on complication rate between study group and control group(P>0.05). There was no statistical significance on preoperative measurement data(P>0.05). Conclusion: For OSAHS patients with obstructive level at retropalatal plane and nasal plane, Han-uvulopalatopharyngoplasty combined with septoplasty in one stage is safe and effective.

Nasal septum suture combined with inferior turbinate coblation after septoplasty: Does it improve quality of life and reduce complications?

ObjectiveNasal packing is routinely applied after septoplasty. Patients, however, report feeling very uncomfortable while the packing is in place. The aim of this study was to compare the effects of nasal septum suture combined with inferior turbinate coblation to the effects of nasal packing after septoplasty.MethodsIn this study, 135 patients undergoing septoplasty were divided into 3 groups: group 1 patients had microdebrider with packing, group 2 received coblation with packing and group 3 had coblation with suture. Early postoperative quality of life and complications were compared between the 3 groups.ResultsThe patients in group 1 experienced the most postoperative nasal pain, headache, dysphagia, sleep disturbance and bleeding on the night of surgery; while the patients in group 3 experienced the fewest symptoms. No difference in epiphora was observed between the 3 groups. More pain and bleeding were experienced when comparing the pack removal (Group 1 and 2) with the clearance of the nasal cavity (Group 3). We noted one case of postoperative bleeding in group 1, one septal hematoma in group 1 and a second septal hematoma in group 2. No such postoperative complications were found in group 3.ConclusionNasal septum suture combined with inferior turbinate coblation was not only associated with less pain, increased patient satisfaction and an improved quality of life; but also reduced postoperative complications. Our results confirm that it is a more comfortable, reliable alternative to the more common nasal packing.

Transconjunctival Orbital Septum Fat Release and Preservation for Orbitopalpebral Sulcus in Lower Eyelid Blepharoplasty.

Compared to the traditional transcutaneous approach, a safe and effective lower eyelid blepharoplasty has been recognized. In 2007, Sadove first reported a series of patients treated with transconjunctival septal suturing, but the inferior orbitopalpebral sulcus was not totally improved. Orbital septal fat release and preservation through the transconjunctival approach was used to treat 20 young patients with bulging bags and inferior orbitopalpebral sulcus. The orbital septal fat was released and transferred to infraorbital rim to be a base for the inferior orbitopalpebral sulcus. Obvious bulging fat was released, and the orbitopalpebral sulcus was flattened by released and excessive orbital septal fat. Satisfactory results were achieved. The results achieved from this series of patients indicate that orbital septal fat release and preservation through the transconjunctival approach for reducing the orbitopalpebral sulcus is a safe and effective treatment for bulging fat and orbitopalpebral sulcus in young patients. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Nasal Septal Chain Suture: A New Suturing Technique.

As a new technique for suturing the nasal septum, the nasal septal chain suture has been described in this study, and compared with nasal packing and the quilting suture technique in terms of patient comfort after septoplasty. A total of 75 patients were evaluated in 3 groups: Merocel nasal packing group, absorbable quilting suture group, and nonabsorbable nasal septal chain suture group. The symptoms of these patients were evaluated using the nasal obstruction symptom evaluation (NOSE) scale and rhinomanometry measurements. The NOSE scale values were significantly higher on the postoperative 1st and 3rd days in the nasal packing group (P < 0.001 and P < 0.001, respectively). The nasal resistance was significantly lower (P = 0.011) and the nasal airflow significantly higher (P < 0.001) in the suture groups on the postoperative 3rd day. The use of nasal packing was found to shorten the surgery duration significantly (P < 0.001), while there was no difference between the 2 suture groups (P = 1.000). There was significantly severe pain during the removal of the nasal packing when compared to the nasal septal chain suture removal (P < 0.001), but there was no difference in the bleeding (P = 0.460). Overall, nasal septal sutures significantly improve patient comfort during the postoperative period, when compared to nasal packing, with an earlier return to nasal respiration. The nasal septal chain suture that has been described in this study for the first time can be an alternative to nasal packing and the nasal septal suture techniques currently in use, since both absorbable and nonabsorbable materials can be used, it is easy to remove, and there is no pain during the suture removal.

Sepia from the Miocene of the Central Paratethys: new taxa and notes on late Cenozoic cuttlefish diversity

A new and locally abundant species of Sepia, S. juliebarborarum sp. nov., and single records of S. aff. loerentheyi and S. aff. sanctacrucensis from the upper Badenian of Slovakia and Austria, S. mikuzi sp. nov., S. aff. mikuzi sp. nov. and Sepia sp. from the middle Badenian of Slovenia, document a greater Miocene sepiid diversity in the Central Paratethys than previously recorded. In the present study, Miocene sepiids from the Central Paratethys are systematically revised and, in part, compared to other coeval taxa from elsewhere. Middle Miocene diversity in the Central Paratethys amounts to nine species, inclusive of four taxa retained in open nomenclature. Here we use the morphology of the dorsal shield and septal suture lines as key features for systematic assignment at the species level. Usage of the generic name Sepia for these Miocene sepiids is corroborated by uniquely preserved material of S. vindobonensis from the middle Badenian of Austria. This reveals only minor morphological differences during ontogeny from the Recent type species of Sepia, S. officinalis. The stratigraphical range of sepiids in the Central Paratethys is reinterpreted and shown to be early to late Badenian. Miocene Sepia diversity in the Central Paratethys is greater than previously supposed, which supports normal marine conditions and an open connection with the Mediterranean.http://zoobank.org/urn:lsid:zoobank.org:pub:3B32BA47-EB28-4A75-95FE-6349C08BB5EA.