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Published in: Clinical Oral Investigations 9/2018

Open Access 01-12-2018 | Original Article

The use of throat packs in pediatric cleft lip/palate surgery: a retrospective study

Authors: B. J. A. Smarius, C. H. A. L. Guillaume, G. Jonker, A. B. Mink van der Molen, C. C. Breugem

Published in: Clinical Oral Investigations | Issue 9/2018

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Abstract

Objectives

Throat packs are commonly used to prevent ingestion or aspiration of blood and other debris during cleft lip/palate surgery. However, dislodgement or (partial) retainment after extubation could have serious consequences. The aim of the present study was to investigate the effect of omitting pharyngeal packing during cleft lip/palate surgery on the incidence of early postoperative complications in children.

Materials and methods

A retrospective study was performed on all children who underwent cleft lip/palate surgery at the Wilhelmina Children’s Hospital. This study compared the period January 2010 through December 2012 when pharyngeal packing was applied according to local protocol (group A) with the period January 2013 till December 2015 when pharyngeal packing was no longer applied after removal from the protocol (group B). Data were collected for sex, age at operation, cleft lip/palate type, type of repair, lateral incisions, length of hospital stay, and complications in the first 6 weeks after surgery. Early complications included wound dehiscence, postoperative bleeding, infection, fever, upper respiratory tract infection (URTI), and lower respiratory tract infection (LRTI).

Results

This study included 489 cleft lip/palate operations (group A n = 246, group B n = 243). A total of 39 (15.9%) early complications were recorded in group A and a total of 40 (16.5%) in group B. There were no significant differences (P = 0.902) in complications between the two groups; however, there was a significant difference (P < 0.001) in length of hospital stay between the two groups (group A 3.6 days vs group B 3.2 days).

Conclusion

Omitting routine placement of throat packs in cleft lip/palate surgery was not associated with an increased early postoperative complication rate. Therefore, the traditional, routine placement of a throat pack during cleft lip/palate surgery can be questioned.

Clinical relevance

The traditional, routine placement of a throat pack during cleft lip/palate surgery can be questioned.
Literature
1.
go back to reference Scheck PA (1981) A pharyngeal pack fixed on to the tracheal tube. Anaesthesia 36:892–895CrossRef Scheck PA (1981) A pharyngeal pack fixed on to the tracheal tube. Anaesthesia 36:892–895CrossRef
2.
go back to reference Green RA, Akester J (1981) A combined oropharyngeal airway and dental pack. Anaesthesia 36:889–891CrossRef Green RA, Akester J (1981) A combined oropharyngeal airway and dental pack. Anaesthesia 36:889–891CrossRef
3.
go back to reference Vickery IM, Burton GW (1977) Throat packs for surgery. An improved design based on anatomical measurements. Anaesthesia 32:565–572CrossRef Vickery IM, Burton GW (1977) Throat packs for surgery. An improved design based on anatomical measurements. Anaesthesia 32:565–572CrossRef
4.
go back to reference Sexton J, Dohlman L (1989) Benefits of the pharyngeal pack. J Oral Maxillofac Surg 47:891CrossRef Sexton J, Dohlman L (1989) Benefits of the pharyngeal pack. J Oral Maxillofac Surg 47:891CrossRef
5.
go back to reference To EW, Tsang WM, Yiu F et al (2001) A missing throat pack. Anaesthesia 56:383–384CrossRef To EW, Tsang WM, Yiu F et al (2001) A missing throat pack. Anaesthesia 56:383–384CrossRef
6.
go back to reference Najjar MF, Kimpson J (1995) A method for preventing throat pack retention. Anesth Analg 80:208–209PubMed Najjar MF, Kimpson J (1995) A method for preventing throat pack retention. Anesth Analg 80:208–209PubMed
7.
8.
go back to reference Burden RJ, Bliss A (1997) Residual throat pack—a further method of prevention. Anaesthesia 52:806PubMed Burden RJ, Bliss A (1997) Residual throat pack—a further method of prevention. Anaesthesia 52:806PubMed
13.
go back to reference Mann RJ, Fisher DM (1997) Bilateral buccal flaps with double opposing Z-plasty for wider palatal clefts. Plast Reconstr Surg 100:1139–1143 discussion 1144-1135CrossRef Mann RJ, Fisher DM (1997) Bilateral buccal flaps with double opposing Z-plasty for wider palatal clefts. Plast Reconstr Surg 100:1139–1143 discussion 1144-1135CrossRef
14.
go back to reference Seraj MA, Ankutse MM, Khan FM, Siddiqui N, Ziko AO (1991) Tracheal soiling with blood during intranasal surgery—comparison of two endotracheal tubes. Middle East J Anaesthesiol 11:79–89PubMed Seraj MA, Ankutse MM, Khan FM, Siddiqui N, Ziko AO (1991) Tracheal soiling with blood during intranasal surgery—comparison of two endotracheal tubes. Middle East J Anaesthesiol 11:79–89PubMed
15.
go back to reference Conway CM, Miller JS, Sugden FL (1960) Sore throat after anaesthesia. Br J Anaesth 32:219–223CrossRef Conway CM, Miller JS, Sugden FL (1960) Sore throat after anaesthesia. Br J Anaesth 32:219–223CrossRef
16.
go back to reference Karbasforushan A, Hemmatpoor B, Makhsosi BR, Mahvar T, Golfam P, Khiabani B (2014) The effect of pharyngeal packing during nasal surgery on the incidence of post operative nausea, vomiting, and sore throat. Iran J Otorhinolaryngol 26:219–223PubMedPubMedCentral Karbasforushan A, Hemmatpoor B, Makhsosi BR, Mahvar T, Golfam P, Khiabani B (2014) The effect of pharyngeal packing during nasal surgery on the incidence of post operative nausea, vomiting, and sore throat. Iran J Otorhinolaryngol 26:219–223PubMedPubMedCentral
18.
go back to reference von Schoenberg M, Robinson P, Ryan R (1993) Nasal packing after routine nasal surgery—is it justified? J Laryngol Otol 107:902–905CrossRef von Schoenberg M, Robinson P, Ryan R (1993) Nasal packing after routine nasal surgery—is it justified? J Laryngol Otol 107:902–905CrossRef
20.
go back to reference Sharma PK, Bhakta P, Srinivasan S, Khan RM, Kaul N (2012) Acute tongue enlargement secondary to pharyngeal packing after tracheal intubation—a case report. Middle East J Anaesthesiol 21:761–764PubMed Sharma PK, Bhakta P, Srinivasan S, Khan RM, Kaul N (2012) Acute tongue enlargement secondary to pharyngeal packing after tracheal intubation—a case report. Middle East J Anaesthesiol 21:761–764PubMed
24.
go back to reference Kawaguchi M, Sakamoto T, Ohnishi H, Karasawa J (1995) Pharyngeal packs can cause massive swelling of the tongue after neurosurgical procedures. Anesthesiology 83:434–435CrossRef Kawaguchi M, Sakamoto T, Ohnishi H, Karasawa J (1995) Pharyngeal packs can cause massive swelling of the tongue after neurosurgical procedures. Anesthesiology 83:434–435CrossRef
25.
go back to reference Kobus K (1984) Extended vomer flaps in cleft palate repair: a preliminary report. Plast Reconstr Surg 73:895–903CrossRef Kobus K (1984) Extended vomer flaps in cleft palate repair: a preliminary report. Plast Reconstr Surg 73:895–903CrossRef
Metadata
Title
The use of throat packs in pediatric cleft lip/palate surgery: a retrospective study
Authors
B. J. A. Smarius
C. H. A. L. Guillaume
G. Jonker
A. B. Mink van der Molen
C. C. Breugem
Publication date
01-12-2018
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 9/2018
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-018-2387-0

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