Throat packs in ENT surgery

Throat packs in ENT surgery. Throat packs are sometimes used in oral and sinonasal surgery to prevent contamination of the upper aerodigestive track and reduce the risk of postoperative aspiration. At present there is much variability in the use of throat packs, with little data on current practice. An anonymous electronic survey of Australian ENT surgeons was performed. Responses from 314 ENT surgeons (63.3%) were collected. In cases with an endotracheal tube, throat packs were preferred by 35.0% of surgeons, falling to 16.9% with a laryngeal mask airway. 61.8% of surgeons never use a throat pack with a laryngeal mask airway of any description. Throat packs tend to be favoured in cases with high bleeding risk, such as sphenopalatine artery ligation, complex FESS, and medial maxillectomy, and they are less utilised in cases with low bleeding risk, such as linear cautery of turbinates, reduction of nasal fracture, and wedge resection of lip. Respondents described 165 critical incidents related to throat pack insertion, and 53 critical incidents possibly preventable by throat pack insertion. This survey describes the current practice of throat packs insertion by Australian ENT surgeons. Further study is required to determine the current practice of our anaesthetic colleagues, and a consensus should be reached to streamline our perioperative clinical decision making.