PHARYNGEAL PACKING IN SINONASAL SURGERY: A SYSTEMATIC REVIEW AND META-ANALYSIS.
Main Article Content
Keywords
pharyngeal packing, sinonasal surgery, meta-analysis
Abstract
Background: Pharyngeal packs are used during nasal surgery to physically stop blood flow into the aerodigestive tract, which has strong emetic effects. Although it has been hypothesized that utilizing it decreases postoperative nausea and vomiting (PONV), this has not been verified.
Objectives: This study aimed to assess the effect of pharyngeal packing in sinonasal surgery regarding postoperative nausea, vomiting, and sore throat.
Methods: PubMed and EBSCO database information services were used for article selection. All articles relevant to our topic were included, and other articles were reviewed. Articles that were unrelated to this field were excluded. Additionally, data were extracted in a specific format that group members reviewed.
Results: Using a random-effects model, we performed a meta-analysis of case-control data on six studies regarding the incidence of nausea, vomiting, and pain, and we observed that pharyngeal packing had no significant influence on nausea, vomiting, or sore throat (P > 0.05); however, data for throat pain were few and heterogeneous.
Conclusion: All studies reported that pharyngeal packing had no advantages or disadvantages in sinonasal surgery. Despite being widely practiced, using various methods of pharyngeal packing or without packing has no significant impact on the incidence of PONV or throat pain. However, applying a pharyngeal pack does not worsen the patient's postoperative throat pain or have adverse effects.
References
2. Jin HJ, Kim S, Hwang SH. Can Pharyngeal Packing Prevent Postoperative Nausea and Vomiting in Nasal Surgery?. Laryngoscope. 2019;129(2):291-298. doi:10.1002/lary.27189
3. Elhakim M. A comparison of intravenous ketoprofen with pethidine for postoperative pain relief following nasal surgery. Acta Anaesthesiol Scand. 1991;35(4):279-282. doi: 10.1111/j.1399-6576.1991.tb03289.x.
4. 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):1161-1165. doi: 10.1111/j.1365-2044.2006.04868.x.
5. 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):552-554. doi: 10.1016/j.otohns.2007.04.004.
6. Knepil GJ, Blackburn CW. Retained throat packs: results of a national survey and the application of an organizational accident model. Br J Oral Maxillofac Surg. 2008;46(6):473-476. doi: 10.1016/j.bjoms.2008.02.005.
7. Meco BC, Ozcelik M, Yildirim Guclu C, et al. Does type of pharyngeal packing during sinonasal surgery have an effect on PONV and throat pain? Otolaryngol Head Neck Surg. 2016;154(4):742-747. doi: 10.1177/0194599815626126.
8. Karbasforushan A, Hemmatpoor B, Makhsosi BR, Mahvar T, Golfam P, Khiabani B. The effect of pharyngeal packing during nasal surgery on the incidence of postoperative nausea, vomiting, and sore throat. Iran J Otorhinolaryngol. 2014;26(77):219-223.
9. 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):181-183. doi: 10.1007/s11845-010-0601-4.
10. Weber R, Keerl R, Hochapfel F, Draf W, Toffel PH. Packing in endonasal surgery. Am J Otolaryngol. 2001;22(5):306-320. doi: 10.1053/ajot.2001.26499.
11. Kennedy DW, Bolger WE, Zinreich SJ. Diseases of the Sinuses: Diagnosis and Management. Hamilton: B C Decker, Inc; 2001:16B.
12. Rizvi MM, Singh RB, Rasheed MA, Sarkar A. Effects of different types of pharyngeal packing in patients undergoing nasal surgery: A comparative study. Anesth Essays Res. 2015;9(2):230-237. doi: 10.4103/0259-1162.156347.
13. Korkut AY, Erkalp K, Erden V, et al. Effect of pharyngeal packing during nasal surgery on postoperative nausea and vomiting. Otolaryngol Head Neck Surg. 2010;143(6):831-836. doi: 10.1016/j.otohns.2010.08.030.
14. Alfiky MG, Margalani OA, Rajeh AF, et al. Nasopharyngeal versus hypopharyngeal packing during sino-nasal surgeries: randomised controlled trial. Clin Otolaryngol. 2018;43(5):1235-1241. doi: 10.1111/coa.13132.
15. Green R, Konuthula N, Sobrero M, et al. Use of pharyngeal packs in functional endoscopic sinus surgery: A randomized controlled trial. Laryngoscope. 2017;127(11):2460-2465. doi: 10.1002/lary.26651.
16. D’Angelo R, Philip B, Gan TJ, et al. A randomized, double-blind, close-ranging, pilot study of intravenous granisetron in the prevention of postoperative nausea and vomiting in patients abdominal hysterectomy. Eur J Anaesthesiol. 2005;22(10):774-779.
doi: 10.1017/s0265021505001286.
17. Conway CM, Miller JS, Sugden FL. Sore throat after anaesthesia. Br J Anaesth. 1960;32:219-223. doi: 10.1093/bja/32.5.219.
18. 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):60-63. doi: 10.1054/bjom.2001.0753.
19. Fine J, Kaltman S, Bianco M. Prevention of sore throat after nasotracheal intubation. J Oral Maxillofac Surg. 1988;46(11):946-947. doi: 10.1016/0278-2391(88)90331-x.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Abdullah M. Assiri
Assistant Professor of Otorhinolaryngology, Head and Neck Surgery, Department of Surgery, College of Medicine, Najran University, Kingdom of Saudi Arabia.
Batool Hamad Hussain Alyami
Department of Surgery, College of Medicine, Najran University, Kingdom of Saudi Arabia.
Aljoharah Ali H Alzabin
Department of Surgery, College of Medicine, Najran University, Kingdom of Saudi Arabia.
Hatim Saleh M Karhan
Department of Surgery, College of Medicine, Najran University, Kingdom of Saudi Arabia.
Mahdi Turki Bin Ali Alfataih
Department of Surgery, College of Medicine, Najran University, Kingdom of Saudi Arabia.
Alhassan Ahmed M Al Dundur
Department of Surgery, College of Medicine, Najran University, Kingdom of Saudi Arabia.
Ali Mahdi J Alyami
Department of Surgery, College of Medicine, Najran University, Kingdom of Saudi Arabia.
Saleh Mohammed Saleh Al Kulayb
Department of Surgery, College of Medicine, Najran University, Kingdom of Saudi Arabia.
Fatimah Ismail A Alrajab
Department of Surgery, College of Medicine, Najran University, Kingdom of Saudi Arabia.
Amjad Abdullah Mohammed Alkhawaji
Department of Surgery, College of Medicine, Najran University, Kingdom of Saudi Arabia.