Risks of Pharyngeal Pack Use Following FESS Outweigh Benefits

Do pharyngeal packs have an effect on postoperative pain and postoperative nausea and vomiting in functional endoscopic sinus surgery (FESS)?

Bottom line
There was no significant difference in mean throat pain at four hours following surgery or level of nausea at four hours and 24 hours after surgery; the difference in pain levels at 24 hours after surgery may be explained by other phenomena. The authors advise against using the packs due to potential risks.

Background: It is thought that pharyngeal packs prevent cartilage and bony debris aspiration and blood product ingestion during FESS, thereby decreasing the incidence of postoperative nausea and vomiting (PONV). Studies have failed to show this connection adequately, and the pharyngeal packs can increase some complications, including postoperative throat pain and aphthous stomatitis.

Study design: Powered, double-blinded randomized control trial of 46 patients scheduled for routine endoscopic sinus surgery, randomly allocated to pharyngeal packing and control groups.

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