Interest of pharyngeal packing in head and neck surgery: a meta-analysis

Introduction: There is controversy regarding the use of pharyngeal packing in oral and nasal surgery. The primary objective of this study was to examine the association between pharyngeal packing, throat pain, and postoperative nausea and vomiting (PONV) in head and neck surgery. Material and methods: A systematic review of clinical studies published from January 2000 to August 2020 concerning the use of pharyngeal packing in head and neck surgery was conducted in the Medline, ScienceDirect and Cochrane Library databases. Throat pain and PONV were collected in each article, and a meta-analysis was performed. Results: A total of 10 clinical trials involving 877 patients were included in the meta-analysis. Pharyngeal packing did not significantly decrease PONV score either during the immediate (OR = 0.90, 95% CI: 0.59 to 1.38, p = 0.52, I2 = 0%) or the delayed postoperative period (OR = 0.88, 95% CI: 0.54 to 1.43, p = 0.28, I2 = 21%), but significantly increased the immediate postoperative throat pain score (MD = 0.68, 95% CI: 0.21 to 1.16, p = 0.19, I2 = 35%). Conclusion: This study suggests that the use of a pharyngeal packing to improve the preoperative aftermath in head and neck surgery should not be recommended.