Pharyngeal packing is a predisposing factor for postoperative aphthous stomatitis in nasal surgery

Kerem, Eitan; Korkut, Yasemin; Meriç, Ayşenur; Kahya, Volkan; Gedikli, Orhan; Su, Özlem; Saitoglu, Leyla

doi:10.1016/j.otohns.2009.12.040

Cited by 26 publications

(28 citation statements)

References 16 publications

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“…From 76 unique studies, we excluded 33 (Figure 1): 11 studies that did not test RAS treatments (Arvola et al , 2006; Sunitha and Shanmugam, 2006; Akman et al , 2007; Yoshihara et al , 2007; van der Hilst et al , 2008; Yao et al , 2008; Lebranchu et al , 2009; Chams‐Davatchi et al , 2010; Davatchi et al , 2010; Erkalp et al , 2010; Perico et al , 2010), 11 studies without a statistical comparison to a control arm (Kaufman et al , 2005; Sharquie and Hayani, 2005; Akhionbare and Ojehanon, 2007; Sharma et al , 2007; Karaca et al , 2008; Lee et al , 2008; Nanke et al , 2008; Mimura et al , 2009; Ciancio et al , 2010; Hello et al , 2010; Yasui et al , 2010), and eleven other studies (Moezzi et al , 2005; Brignone et al , 2007; Chuang and Langone, 2007; Passarini et al , 2007; Renko et al , 2007; Burgess, 2009; Garavello et al , 2009; Koray et al , 2009; Pignatello et al , 2009; Volkov et al , 2009Budde et al , 2011).…”

Section: Resultsmentioning

confidence: 99%

Urban legends: recurrent aphthous stomatitis

et al. 2011

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Recurrent aphthous stomatitis (RAS) is the most common idiopathic intraoral ulcerative disease in the USA. Aphthae typically occur in apparently healthy individuals, although an association with certain systemic diseases has been reported. Despite the unclear etiopathogenesis, new drug trials are continuously conducted in an attempt to reduce pain and dysfunction. We investigated four controversial topics: (1) Is complex aphthosis a mild form of Behçet’s disease (BD)? (2) Is periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome a distinct medical entity? (3) Is RAS associated with other systemic diseases (e.g., celiac disease and B12 deficiency)? (4) Are there any new RAS treatments? Results from extensive literature searches, including a systematic review of RAS trials, suggested that: (1) Complex aphthosis is not a mild form of BD in North America or Western Europe; (2) Diagnostic criteria for PFAPA have low specificity and the characteristics of the oral ulcers warrant further studies; (3) Oral ulcers may be associated with celiac disease; however, these ulcers may not be RAS; RAS is rarely associated with B12 deficiency; nevertheless, B12 treatment may be beneficial, via mechanisms that warrant further study; (4) Thirty-three controlled trials published in the past 6 years reported some effectiveness, though potential for bias was high.

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Section: Resultsmentioning

confidence: 99%

Urban legends: recurrent aphthous stomatitis

et al. 2011

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“…14 Following this review, three randomised controlled trials with relatively large number of patients showed that hypopharyngeal packs have no effect on throat pain and PONV. 9,10,15 This contradicts the results of Erkalp et al 16 ,…”

Section: Discussionmentioning

confidence: 61%

“…Following this review, three randomised controlled trials with relatively large number of patients showed that hypopharyngeal packs have no effect on throat pain and PONV . This contradicts the results of Erkalp et al, who reported that hypopharyngeal packs can result in significantly increased incidence of aphthous stomatitis and throat pain in the first 3 days following nasal surgery. In our study, there was only one patient with the hypopharyngeal pack who developed ulceration after 24 hours.…”

Section: Discussionmentioning

confidence: 68%

Nasopharyngeal versus hypopharyngeal packing during sino‐nasal surgeries: Randomised controlled trial

Alfiky

Margalani

Rajeh

et al. 2018

Clinical Otolaryngology

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“…Second, it can increase the incidence of PONV [18,19]. Although some researchers have found that PP does not reduce PONV, and that it increases postoperative aphthous stomatitis and sore throat [3], many anaesthesiologists believe that PP prevents PONV by creating a physical barrier for the entry of blood from the throat into the stomach during NS [6,15]. In our study, only patients who underwent septoplasty surgery, PP was decreased PONV incidence and severity at the first four hours, postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of postoperative nausea and vomiting (PONV) due to perioperative blood ingestion (PBI) in nasal surgery (NS) is 34-60% [1][2][3]. Blood is a potent emetic [4].…”

Section: Introductionmentioning

confidence: 99%

A randomized, double-blind study of the ultrasound assessment of the effect of pharyngeal packing on perioperative gastric volume in nasal surgery

Temel

Totoz

Müslümanoğlu

et al. 2019

Preprint

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Background: Pharyngeal packing (PP) is commonly performed to reduce the incidence of perioperative blood ingestion (PBI) in nasal surgery (NS), and thus the incidence and severity of postoperative nausea and vomiting (PONV). This study examined the effects of PP on the perioperative gastric volume (GV) and PONV in patients undergoing NS, by ultrasound assessment. Methods: Patients undergoing elective NS [septoplasty, septo-rhinoplasty (SRP) and functional endoscopic sinus surgery (FESS)] were randomised to receive or not receive PP. In the PP group, pharyngeal packs were placed after the orotracheal intubation. Ultrasound assessments were performed for all patients preoperatively (before the anaesthesia induction) and postoperatively (before the extubation). The antero-posterior (AP) and cranio-caudal (CC) antral diameters, antral cross-sectional area (ACSA), and total GV were calculated. PONV incidence and severity were rated. These variables were compared between timepoints and groups, and in the subgroup analyses according to the surgery type. Pearson correlation analysis was performed to assess correlations between the variables. Results: AP and CC diameters and ACSAs were greater postoperatively than preoperatively in the PP and non-PP groups (n = 44 each; all p < 0.05). Postoperative AP and CC diameters and the ACSA were greater in the non-PP than in the PP group (all p < 0.05). Postoperative AP diameters were greater than preoperatively in patients undergoing SRP and FESS, and the postoperative CC diameter and ACSA were greater than preoperatively in patients undergoing SRP (all p < 0.05). Surgery duration was correlated positively with postoperative AP diameter (r = 0.380, p < 0.05), CC diameter (r = 0.291, p < 0.05), and ACSA (r = 0.369, p < 0.05). Patients who underwent septoplasty surgery, PP was decreased PONV incidence and severity at the first four hours, postoperatively (p < 0.05). Conclusions: The study findings indicate that PP reduces the increase in the perioperative GV due to PBI in an elective NS. It is therefore a useful and safe means of reducing the risk of perioperative pulmonary aspiration in such surgeries.

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Pharyngeal packing is a predisposing factor for postoperative aphthous stomatitis in nasal surgery

Abstract: Pharyngeal packing during nasal surgery increases postoperative morbidity by leading to the development of painful oral aphthous lesions.

Cited by 26 publications

References 16 publications

Urban legends: recurrent aphthous stomatitis

Urban legends: recurrent aphthous stomatitis

Nasopharyngeal versus hypopharyngeal packing during sino‐nasal surgeries: Randomised controlled trial

A randomized, double-blind study of the ultrasound assessment of the effect of pharyngeal packing on perioperative gastric volume in nasal surgery

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