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Updated: Sep 16, 2025
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Throat pack usage in dacryocystorhinostomy (DCR) - systematic review & multicentre international survey revealing
Charlotte Zhang1, Clare Quigley2,3, James Pietris1,2,3
1School of Medicine, University of Adelaide, Adelaide, SA, Australia.
Purpose:
Throat packs are used in endonasal surgery to absorb blood and secretions, theoretically reducing aspiration risk and post-operative nausea/vomiting. However, complications have been documented in the literature, and there is no clear consensus on the indications and method of use. This study aims to review the literature on throat pack use in dacryocystorhinostomy (DCR), and investigate the practices and views of anaesthetists, oculoplastic and ENT surgeons.
Methods:
A systematic search of the PubMed/MEDLINE, Embase, and CENTRAL databases was performed. Data was collected and risk of bias assessed in accordance with PRISMA guidelines. A survey was also distributed to UK and Australian anaesthetists, ENT, and oculoplastic surgeons.
Results:
The systematic review identified a lack of evidence supporting use of throat packs in DCR. Of the 82 respondents to the survey, 48% only use a pack if requested by another clinician, 23% never used, 12% used in every DCR, 11% used only in DCR with high risk of bleeding/aspiration, and 6% selected "other." ENT surgeons were least likely to use throat packs (64% never use, p = .002). Clinical experience did not influence usage. Individuals who believed throat packs were equally beneficial for both endonasal and external surgical approaches used them more often (p = .002). The most common complications of throat pack use observed were throat pain (57.3%) and mucosal injury (30.5%).
Conclusions:
The findings highlight the arbitrary nature of throat pack use in DCR and the need for evidence-based guidelines, particularly in the presence of clear complications that have been observed.
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