Throat packing via nasopharyngeal airway for severe trismus cases requiring surgical intervention under general anesthesia: A simplified and innovative approach

J Stomatol Oral Maxillofac Surg. 2024 Sep;125(4S):101944. doi: 10.1016/j.jormas.2024.101944. Epub 2024 Jun 7.

Abstract

Throat packing is essential in oral and maxillofacial surgeries to prevent blood and tissue debris aspiration, reducing postoperative complications. Traditional oral route methods are often inadequate, especially in severe trismus cases like Oral Submucous Fibrosis (OSMF), TMJ Ankylosis, and post-traumatic conditions due to limited mouth opening. This study introduces a novel technique using a nasopharyngeal airway (NPA) for throat packing. The method involves inserting a hemostatic dressing through an NPA, ensuring minimal invasiveness and effective airway management. Proper positioning is confirmed with a laryngoscope or fiberoptic scope, and the dressing is secured to prevent dislodgement. This technique is easy, reproducible, and less injurious compared to traditional methods. At our center, throat packing via NPA was performed on 35 patients undergoing surgery under general anesthesia, resulting in high satisfaction and no reported complications.

Keywords: Nasopharyngeal airway; Oral and maxillofacial surgery; Oral submucous fibrosis; Throat packing; Trismus.

MeSH terms

  • Adult
  • Anesthesia, General* / methods
  • Bandages
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nasopharynx / surgery
  • Pharynx / surgery
  • Trismus* / etiology
  • Trismus* / surgery
  • Trismus* / therapy