Abstract
A postoperative radiograph demonstrated a folded radio-opaque structure in the nasopharynx, resembling a retained throat pack, despite her not having any respiratory symptoms. Retention of a throat pack is a never event.
Keywords: Throat pack, Scrunchy
Case history
A 28-year-old woman underwent bimaxillary osteotomies for the correction of malocclusion and facial disproportion. The postoperative radiograph (Fig 1) demonstrated the immediate surgical outcome, and plate placement. It also showed a folded radio-opaque structure, which appeared to be in the nasopharynx, resembling a retained throat pack, despite her not having any respiratory symptoms. Retention of a throat pack is a never event.1,2
Figure 1.
The postoperative radiograph showing a folded radio-opaque structure in the nasopharynx, resembling a retained throat pack.
This turned out to be an artefact; the ‘throat pack’ was a scrunchy: a piece of elastic covered in material, used to hold long hair at the back of the head. In our case, the scrunchy’s structure was reinforced with wire, hence the radiographic appearance, mimicking a throat pack when it was superimposed.
Many objects can cause confusion when superimposed on radiographs. In this case, the unfortunate positioning of the artefact and the resemblance to the radio-opaque marker placed in throat packs led to initial confusion. Scrunchies, and indeed other hair care accessories, may cause diagnostic difficulties, and those of us who are follicularly challenged need to be especially aware of these risks.
References
- 1.National Patient Safety Agency Reducing the Risk of Retained Throat Swabs after Surgery. London: NPSA; 2009. https://www.medis-medical.com/content-files/NPSA-Report-Reducing-Risk-Retained-Throat-Packs-Surgery.pdf (cited March 2020). [Google Scholar]
- 2.NHS Improvement. Never Events List 2018. https://improvement.nhs.uk/resources/never-events-policy-and-framework (cited March 2020).