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November 19, 1982

Nasal Packing After Surgery

JAMA. 1982;248(19):2452. doi:10.1001/jama.1982.03330190022020

To the Editor.—  Thomas et al reported a case of toxic shock syndrome (TSS) thought to have been a result of nasal packing after submucous resection and rhinoplasty (1982;247:2402).Bacteremia and local infections with nasal packing are familiar and long-recognized problems to many nasal surgeons.1 Other potential and actual complications of packing include a dry throat, difficulty swallowing, aspiration, pressure necrosis, hypoxemia, postoperative swelling and edema, rhinorrhea, and bleeding after removal of the packing. Sometimes overly aggressive packing after rhinoplasty can result in spreading of osteotomized nasal bones, which compromises the final result.Stucker and Ansel2 have discussed the pros and cons of nasal packing after surgery. They outline conservative indications that include support of bony fragments, control of bleeding, coaptation of the septal flaps, and, in certain cases, technical expediency. They found in reviewing more than 800 nasal surgeries that fewer than 9% required packing. The present