Pharyngeal Packing during Rhinoplasty: Advantages and Disadvantages

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. 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. 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. 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.