Eliminating the Toynbee phenomenon in patients with nasal packs.

Nasal packing is a common procedure in otolaryngology, but is not a completely innocuous procedure. Besides aggravating mouth breathing, complete nasal obstruction results in an annoying Toynbee phenomenon. In patients with bilateral anterior nasal packing, we recorded high pressure gradients in the nasopharynx and, in consequence, in the middle ear. Patients in whom rubber tubes were inserted between the gauze layers of the anterior nasal packs suffered no such inconvenience and showed no such gradients. Our work proves the value of using these tubes for pressure equalization when nasal packs are necessary.