Pharyngeal Packing during Rhinoplasty: Advantages and Disadvantages

Document Type : Original

Authors

1 Cardiac Anesthesia Research Center, Imam-Reza Hospital, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.

2 General Practitioner, Young Researchers Club and elites, Mashhad Branch, Islamic Azad University, Mashhad, Iran.

3 Sinus and Surgical Endoscopic Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction:
Controversy remains as to the advantages and disadvantages of pharyngeal packing during septorhinoplasty. Our study investigated the effect of pharyngeal packing on postoperative nausea and vomiting and sore throat following this type of surgery or septorhinoplasty.
 
Materials and Methods:
This clinical trial was performed on 90 American Society of Anesthesiologists (ASA) I or II patients who were candidates for septorhinoplasty. They were randomly divided into two groups. Patients in the study group had received pharyngeal packing while those in the control group had not. The incidence of nausea and vomiting and sore throat based on the visual analog scale (VAS) was evaluated postoperatively in the recovery room as well as at 2, 6 and 24 hours.
 
Results:
The incidence of postoperative nausea and vomiting (PONV) was 12.3%, with no significant difference between the study and control groups. Sore throat was reported in 50.5% of cases overall (56.8% on pack group and 44.4% on control). Although the severity of pain was higher in the study group at all times, the incidence in the two groups did not differ significantly.
 
Conclusion:
The use of pharyngeal packing has no effect in reducing the incidence of nausea and vomiting and sore throat after surgery. Given that induced hypotension is used as the routine method of anesthesia in septorhinoplasty surgery, with a low incidence of hemorrhage and a high risk of unintended retention of pharyngeal packing, its routine use is not recommended for this procedure. 

Keywords

Main Subjects

References

1. Elyassi H, Mousavinasab M, Rambod M, Hashemian MR, Dabbagh A. The effects of anesthesia method on throat pain after elective rhinoplasty. Int J Prev Med 2011;2(4):275–9.
2. Karbasforushan A, Hemmatpoor B, Makhsosi  BR, Mahvar T, Golfam P, Khiabani B.The Effect of Pharyngeal Packing during Nasal Surgery on the Incidence of Post Operative Nausea, Vomiting,and Sore Throat.Iran J Otorhinolaryngol 2014;26(77): 219-23.
3. Basha SI, McCoy E,Ullah R, Kinsella JB. The efficacy of pharyngeal packing during routine nasal surgery – a prospective randomised controlled study Anaesthesia, 2006; 61(12):1161–65.
4. Fennessy BG, Mannion S, Kinsella JB, O’Sullivan P. The benefits of hypopharyngeal packing in nasal surgery:a pilot study. Ir J Med Sci 2011;180(1):181-3.
5.  Bisase B, Matthews NS, Lan C. Current practice and opinions regarding the use of oropharyngeal throat packs in the United Kingdom. J Patient Saf 2011; 7(3):162–4.
6. Erkalp K, Korkut YA, Meric A, Kahya V, Gedikli O, Su OK, et al. Pharyngeal packing is a predisposing factor for postoperative aphthous stomatitis in nasal surgery. Otolaryngol Head Neck Surg 2010; 142(5):672–6.
7. Sharma PK, Bhakta P, Srinivasan S, Khan RM, Kaul N. Acute tongue enlargement secondary to pharyngeal packing after tracheal intubation--a case report. Middle East J Anaesthesiol 2012; 21(5):761–4.
8. Jaiswal V, Bedford GC. Review of the use of throat packs in nasal surgery. J Laryngol Otol 2009; 123(7):701–4.
9. Korkut AY, Erkalp K, Erden V, Teker AM, Demirel A, Gedikli O, et al. Effect of pharyngeal packing during nasal surgery on postoperative nausea and vomiting. Otolaryngol Head Neck Surg 2010;143(6):831–6.
10. Van den Berg AA. The prophylactic antiemetic efficacy of prochlorperazine and ondansetron in nasal septal surgery: a randomized double-blind compa- rison.Anaesth Intensive Care 1996;24(5):538-45.
11. Tay JY, Tan WK, Chen FG, Koh KF, Ho V. Postoperative sore throat after routine oral surgery: influence of the presence of a pharyngeal pack. Br J Oral Maxillofac Surg 2002;40(1):60–3.
12. Piltcher O, Lavinsky M, Lavinsky J, de Oliveira Basso PR. Effectiveness of hypopharyngeal packing during nasal and sinus surgery in the prevention of PONV. Otolaryngol Head Neck Surg 2007; 137(4):552–4.
13. Colbert S, Jackson M, Turner M, Brennan PA. Reducing the risk of retained throat packs after surgery. Br J Oral Maxillofac Surg 2012; 50(7):680–1
14. Knepil GJ, Blackburn CW. Retained throat packs: results of a national survey and the     application of an organisational accident model. Br J Oral Maxillofac Surg 2008;46(6):473-6.
15. Gan TJ. Risk factors for postoperative nausea and vomiting. Anesth Analg 2006;102(6): 1884–98.
16. Elhakim M, Siam A, Rashed I, Hamdy MH. Topical tenoxicam from pharyngeal pack reduces postoperative sore throat. Acta Anaesthesiol Scand 2000; 44(6):733-6.
17. Marais J, Prescott RJ. Throat pain and pharyngeal packing: a controlled randomized double-blind comparison between gauze and tampons. Clin Otolaryngol Allied Sci 1993; 18(5): 426–9.
Iranian Journal of Otorhinolaryngology
Volume 27, Issue 6 - Serial Number 6
November and December 2015
Pages 423-428

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