{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T11:20:18Z","timestamp":1780399218464,"version":"3.54.1"},"reference-count":38,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Background and Objectives: The insertion of a throat pack is a routine practice during anesthesia in maxillofacial and upper airway surgeries to prevent the aspiration of blood and secretions. However, this technique is associated with postoperative adverse effects such as pharyngitis and nausea. The objective of this systematic review and meta-analysis was to analyze the clinical evidence regarding the effect of throat packs on the incidence of Postoperative Nausea and Vomiting (PONV), throat pain, and gastric volume. Materials and Methods: Conducted according to PRISMA 2020 and registered in PROSPERO (CRD420251027016), an exhaustive search was performed in PubMed, Scopus, WOS, and Cochrane Library. Randomized Controlled Trials (RCTs) comparing throat pack use versus non-use under general anesthesia were included. Quality was assessed using Cochrane RoB 2. Meta-analyses utilized Standardized Mean Difference (SMD) and Mean Difference (MD) through a random-effects model. Results: Fourteen articles (2002\u20132024) involving 1147 patients were included. Methodological quality predominantly raised \u201csome concerns\u201d, with only 7.1% of studies assessed at low risk of bias. Statistical analysis of pain intensity (k = 6) revealed a significant increase in the intervention group (SMD = 0.35; 95% CI: 0.09 to 0.62; p = 0.01). Regarding PONV (k = 3), no statistically significant differences were observed between groups (SMD = \u22120.47; 95% CI: \u22121.51 to 0.58; p = 0.38). Ultrasound measurements showed significant increases in gastric parameters in the throat pack group, including anteroposterior diameter (MD = \u22123.67 mm; p = 0.002) and antral cross-sectional area (MD = \u2212223.10 mm2; p = 0.005). Conclusions: Current evidence does not demonstrate a clear benefit for the routine use of oropharyngeal packing in maxillofacial and upper airway surgeries, and suggests a possible increase in postoperative throat discomfort. While acknowledging the limited number of studies, clinical heterogeneity, and the influence of perioperative co-interventions, these results should be interpreted with caution.<\/jats:p>","DOI":"10.3390\/dj14060337","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T10:14:57Z","timestamp":1780395297000},"page":"337","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Oropharyngeal Packing on Postoperative Nausea, Vomiting, and Throat Discomfort: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9539-6348","authenticated-orcid":false,"given":"Roger","family":"Alonso-Royo","sequence":"first","affiliation":[{"name":"Department of Ciencias Sociales y de la Salud, Centro Department of Ciencias Sociales y de la Salud, Universitario San Isidoro, Affiliated with Pablo de Olavide University (UPO), 41092 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo Trinidad","family":"Vel\u00e1zquez-Cayon","sequence":"additional","affiliation":[{"name":"Department of Ciencias Sociales y de la Salud, Centro Department of Ciencias Sociales y de la Salud, Universitario San Isidoro, Affiliated with Pablo de Olavide University (UPO), 41092 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3883-5980","authenticated-orcid":false,"given":"Pilar","family":"Mart\u00edn-Balbuena","sequence":"additional","affiliation":[{"name":"Department of Ciencias Sociales y de la Salud, Centro Department of Ciencias Sociales y de la Salud, Universitario San Isidoro, Affiliated with Pablo de Olavide University (UPO), 41092 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2719-3282","authenticated-orcid":false,"given":"\u00c1lvaro-Jos\u00e9","family":"Rodr\u00edguez-Dom\u00ednguez","sequence":"additional","affiliation":[{"name":"Department of Ciencias Sociales y de la Salud, Centro Department of Ciencias Sociales y de la Salud, Universitario San Isidoro, Affiliated with Pablo de Olavide University (UPO), 41092 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen Mar\u00eda","family":"S\u00e1nchez-Torrelo","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, University School of Osuna, University of Seville, 41640 Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Shaw, I., Kumar, C., and Dodds, C. (2010). Oxford Textbook of Anaesthesia for Oral and Maxillofacial Surgery, OUP.","DOI":"10.1093\/med\/9780199564217.001.0001"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.1007\/s00011-012-0540-9","article-title":"Environmental and non-infectious factors in the aetiology of pharyngitis (sore throat)","volume":"61","author":"Renner","year":"2012","journal-title":"Inflamm. Res."},{"key":"ref_3","unstructured":"American College of Gastroenterology (2025, April 23). Nausea and Vomiting. Available online: https:\/\/gi.org\/topics\/nausea-and-vomiting\/."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"213","DOI":"10.2165\/00003495-200059020-00005","article-title":"Prevention and treatment of postoperative nausea and vomiting","volume":"59","author":"Kovac","year":"2000","journal-title":"Drugs"},{"key":"ref_5","first-page":"69","article-title":"Recommendations for randomized controlled trials to prevent or treat postoperative nausea and vomiting","volume":"43","author":"Apfel","year":"2002","journal-title":"Anasthesiol. Intensiv."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Higgins, J.P.T., and Thomas, J. (2020). Cochrane Handbook for Systematic Reviews of Interventions, Wiley-Blackwell.","DOI":"10.1002\/9781119536604"},{"key":"ref_7","unstructured":"Deeks, J., Higgins, J., and Altman, D. (2022). Chapter 10: Analysing data and undertaking meta-analyses. Cochrane Handbook for Systematic Reviews of Interventions Version 6.3, Wiley."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1093\/asj\/sjab410","article-title":"Effect of Throat Pack Placement on the Incidence of Sore Throat and Postoperative Nausea and Vomiting in Septorhinoplasty Patients: A Randomized Controlled Trial","volume":"42","author":"Borna","year":"2022","journal-title":"Aesthetic Surg. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.ijom.2021.07.011","article-title":"Do oropharyngeal throat packs prevent fluid ingestion during orthognathic surgery?","volume":"51","author":"Powell","year":"2022","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_11","first-page":"E18\u201321","article-title":"Pharyngeal pack placement in minor oral surgery: A prospective, randomized, controlled study","volume":"97","author":"Syed","year":"2018","journal-title":"Ear Nose Throat J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2460","DOI":"10.1002\/lary.26651","article-title":"Use of pharyngeal packs in functional endoscopic sinus surgery: A randomized controlled trial","volume":"127","author":"Green","year":"2017","journal-title":"Laryngoscope"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1016\/j.otohns.2010.08.030","article-title":"Effect of pharyngeal packing during nasal surgery on postoperative nausea and vomiting","volume":"143","author":"Korkut","year":"2010","journal-title":"Otolaryngol"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1017\/S0022215123001032","article-title":"The effect of pharyngeal packing on gastric volume in patients undergoing nasal surgery: A randomised, controlled trial","volume":"138","author":"Altun","year":"2024","journal-title":"J. Laryngol. Otol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.ijom.2020.05.020","article-title":"Effects of throat packs during orthognathic surgery: A double-blind randomized controlled clinical trial","volume":"50","author":"Faro","year":"2020","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Temel, M., Totoz, T., Erkalp, K., Temel, G., and Selcan, A. (2019). A randomized, double-blind study of the ultrasound assessment of the effect of pharyngeal packing on perioperative gastric volume in nasal surgery. BMC Anesthesiol., 19.","DOI":"10.1186\/s12871-019-0786-7"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3109","DOI":"10.1007\/s00405-017-4589-5","article-title":"A study evaluating the effects of throat packs during nasal surgery: A randomised controlled trial","volume":"274","author":"Kulloo","year":"2017","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_18","first-page":"423","article-title":"Pharyngeal Packing during Rhinoplasty: Advantages and Disadvantages","volume":"27","author":"Razavi","year":"2015","journal-title":"Iran. J. Otorhinolaryngol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/j.otohns.2007.04.004","article-title":"Effectiveness of hypopharyngeal packing during nasal and sinus surgery in the prevention of PONV","volume":"137","author":"Piltcher","year":"2007","journal-title":"Otolaryngol"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1111\/j.1365-2044.2006.04868.x","article-title":"The efficacy of pharyngeal packing during routine nasal surgery\u2014A prospective randomised controlled study","volume":"61","author":"Basha","year":"2006","journal-title":"Anaesthesia"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1054\/bjom.2001.0753","article-title":"Postoperative sore throat after routine oral surgery: Influence of the presence of a pharyngeal pack","volume":"40","author":"Tay","year":"2002","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"6795","DOI":"10.1007\/s00784-022-04641-4","article-title":"Effects of throat packs in upper airway surgery under intubation anesthesia: A randomized controlled trial","volume":"26","author":"Pabst","year":"2022","journal-title":"Clin. Oral Investig."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"9229475","DOI":"10.1155\/tswj\/9229475","article-title":"The Role of Throat Packs in Orthognathic Surgery\u2014A Systematic Review and Meta-Analysis","volume":"2025","author":"Saha","year":"2025","journal-title":"Sci. World J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1051\/mbcb\/2023012","article-title":"Interest of pharyngeal packing in head and neck surgery: A meta-analysis","volume":"29","author":"Casenave","year":"2023","journal-title":"J. Oral Med. Oral Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1111\/coa.13132","article-title":"Nasopharyngeal versus hypopharyngeal packing during sino-nasal surgeries: Randomised controlled trial","volume":"43","author":"Alfiky","year":"2018","journal-title":"Clin. Otolaryngol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1177\/0194599815626126","article-title":"Does Type of Pharyngeal Packing during Sinonasal Surgery Have an Effect on PONV and Throat Pain?","volume":"154","author":"Meco","year":"2016","journal-title":"Otolaryngol.-Head Neck Surg."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Xie, X., Yao, Y., Shi, M., Ding, H., Zhang, D., Jiang, Y., and Guo, T. (2024). The Pharyngeal Packs for Dental and Otolaryngological Surgery: A Meta-Analysis of High-Quality Randomized Controlled Trials. Ear Nose Throat J., Epub ahead of printing.","DOI":"10.1177\/01455613231223352"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1007\/s11845-010-0601-4","article-title":"The benefits of hypopharyngeal packing in nasal surgery: A pilot study","volume":"180","author":"Fennessy","year":"2011","journal-title":"Ir. J. Med. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1007\/s00405-020-06032-5","article-title":"Hypopharyngeal packing during adenotonsillectomy by cold dissection in children: A randomized controlled trial","volume":"277","author":"Oppermann","year":"2020","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_30","first-page":"306","article-title":"The use of throat packs in ear, nose and throat, oral and dental surgery: A systematic review","volume":"58","author":"Anderson","year":"2020","journal-title":"Rhinology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1002\/lary.27189","article-title":"Can Pharyngeal Packing Prevent Postoperative Nausea and Vomiting in Nasal Surgery?","volume":"129","author":"Jin","year":"2019","journal-title":"Laryngoscope"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"230","DOI":"10.4103\/0259-1162.156347","article-title":"Effects of different types of pharyngeal packing in patients undergoing nasal surgery: A comparative study","volume":"9","author":"Rizvi","year":"2015","journal-title":"Anesth. Essays Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1111\/j.1365-2273.1993.tb00607.x","article-title":"Throat pain and pharyngeal packing: A controlled randomized double-blind comparison between gauze and tampons","volume":"18","author":"Marais","year":"1993","journal-title":"Clin. Otolaryngol. Allied Sci."},{"key":"ref_34","first-page":"24","article-title":"Postoperative Sore throat, nausea and vomiting in routine nasal surgery: Influence of pharyngeal packing","volume":"180","author":"Naderian","year":"2012","journal-title":"Galen Med. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1111\/anae.14197","article-title":"Systematic review of benefits or harms of routine anaesthetist-inserted throat packs in adults: Practice recommendations for inserting and counting throat packs","volume":"73","author":"Athanassoglou","year":"2018","journal-title":"Anaesthesia"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.bjoms.2025.02.010","article-title":"The impact of practice recommendations for inserting and counting throat packs: A 12-year analysis of never-events data","volume":"63","author":"Henderson","year":"2025","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1177\/10556656211000553","article-title":"The Throat Pack Debate: A Review of Current Practice in UK and Ireland Cleft Centers","volume":"59","author":"Curran","year":"2022","journal-title":"Cleft Palate Craniofac. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"241","DOI":"10.4103\/ija.IJA_1376_20","article-title":"Current practices and beliefs regarding the use of oropharyngeal throat pack in India: A nationwide survey","volume":"65","author":"Gupta","year":"2021","journal-title":"Indian J. Anaesth."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/6\/337\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T10:50:34Z","timestamp":1780397434000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/14\/6\/337"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,2]]},"references-count":38,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["dj14060337"],"URL":"https:\/\/doi.org\/10.3390\/dj14060337","relation":{},"ISSN":["2304-6767"],"issn-type":[{"value":"2304-6767","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,2]]}}}