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A total of 1035 patients undergoing paranasal sinus surgery in 54 participating medical centers were randomly assigned to suture (n = 519) or stapler (n = 516) closure. All operations were performed by otolaryngology residents under the supervision of attending surgeons. Patients were seen for follow-up by an independent observer 3 weeks, 6 weeks, and 3 months after surgery. The overall healing rate was 98.4% in the suture group and 98.6% in the stapler group. Complications in the suture group were bleeding/hematoma (2%), drainage (6%), and infections (1%). Infections (1%) occurred in the stapler group. These infections were all minor and consisted of purulent rhinorrhea and epistaxis. In both groups, 96% of cases were free of complications at 6 weeks. At 3 months, 57% of suture cases and 51% of stapler cases showed no complication. Healing rates of primary closures of the medial maxillary and the anterior ethmoid sinuses were significantly higher (P = 0.002 and P = 0.001) and of lateral maxillary sinuses marginally higher (P = 0.056) in the suture group. The incidence of recurrent pneumoceles was higher (P = 0.002) in stapled cases. Suture closure in conjunction with rigid nasal packing yielded a slightly higher healing rate in cases of primary closure but was associated with a lower incidence of recurrent pneumoceles. Additional studies are necessary to determine whether the increased incidence of recurrent pneumoceles in stapled cases is clinically significant.Prospective Comparison of a Single Ultrasound-Guided Needle With Direct Curettage for Nodules of the Spine. Accurate visualization of anatomical structures and effective neural parenchyma disruption are both essential for efficient percutaneous biopsy of the spine. 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