Suturing of the nasal septum after septal surgery is a commonly performed procedure designed to prevent complications such as septal haematoma and bleeding. It is also useful for closing any inadvertent tears of the septal mucosa and providing additional support for the cartilage pieces retained in septoplasty. In addition, the suture can be placed through the middle turbinates, stabilising them during the healing process. Placing knots for interrupted sutures in the posterior and middle part of the nasal septum can be technically difficult. We describe a continuous suturing technique for approximating the mucosal flaps following septal surgery.Key words: Nasal Septum; Otorhinolaryngologic Surgical Procedures; Sutures; Haematoma Introduction Many surgeons are adopting an increasingly conservative approach to septal surgery, such that only the deviated portion of the septum is addressed by the surgery. A number of centres are practising endoscopic techniques to perform septal surgery. Following removal of the deviated cartilage or bony septum, a dead space exists. In order to reduce this dead space, and therefore reduce the risk of developing a septal haematoma, surgeons have used nasal packing and suturing techniques. Several suturing techniques have been described to approximate the mucosal flaps after septal procedures, 1 -3 in order to reduce the complication rate. Many surgeons use interrupted sutures using absorbable suture materials to keep the flaps together. In 1984, Sessions 1 reported continuous suture quilting, using 4.0 plain catgut on a small cutting needle to approximate the mucosal flaps. A similar technique using a curved needle was described by Lee and Vukovic. 2 These techniques also help to close any mucosal tears and support the remaining cartilage. Many surgeons use suturing techniques to obviate the need for packing after surgery. 1 In addition, this suturing technique can be used to stabilise the middle turbinates during the healing process, preventing early lateralisation of the turbinate with adhesion formation.We describe a new, endoscopic suturing method for septal mucosal flaps following septal surgery.

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The number of major otological procedures (other than endolymphatic sac surgery) was consistent over the period examined. The generally perceived reduction in the number of procedures performed by individual surgeons may be due to a dilutional effect. This can only support the need for subspecialisation, particularly regarding the training of junior surgeons.

The model provides safe training for the drainage of quinsy.