• V Jaiswal and G C Bedford.
• Department of Ear, Nose and Throat Surgery, Freeman Hospital, High Heaton, Newcastle Upon Tyne, UK. vibhaj@doctors.org.uk
• J Laryngol Otol. 2009 Jul 1;123(7):701-4.

BackgroundThroat packs are employed in nasal surgery to prevent contamination of the upper aerodigestive tract. Their use is thought to reduce the risk of aspiration and post-operative nausea and vomiting. However, use of throat packs may also be accompanied by increased throat pain. In order to inform our clinical practice, the evidence base for throat pack insertion was reviewed.MethodA search was made of the Pubmed database from the 1950s to March 2008. Four randomised, controlled, clinical trials were reviewed.ResultsAll the trials had significant methodological weakness. In all but one, no power calculations were done. There were inconsistencies in the measurement of pain and heterogeneity of rhinological procedures. The one adequately powered trial could not demonstrate a difference in post-operative nausea and vomiting with the use of throat packs (beta error = 20 per cent).ConclusionFurther, adequately powered trials are required involving patients undergoing rhinological procedures with a higher risk of blood contamination (e.g. functional endoscopic sinus surgery), in order to provide definitive evidence on the morbidity of throat packs in rhinological procedures.

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