Posterior packing consists of a gauze roll shaped and secured by three sutures (one suture at each end and one in the middle), or a balloon-type catheter. To insert the packing, the practitioner advances one or two soft catheters into the patient’s nostrils (as shown below). When the catheter tips appear in the nasopharynx, the practitioner grasps them with a Kelly clamp or bayonet forceps and pulls them forward through the mouth. The practitioner secures the two end sutures to the catheter tip and draws the catheter back through the nostrils. This step brings the packing into place with the end sutures hanging from the patient’s nostril. (The middle suture emerges from the patient’s mouth to free the packing, when needed.)The practitioner may weigh the nose sutures with a clamp. Then the practitioner will pull the packing securely into place behind the soft palate and against the posterior end of the septum (nasal choana).Secure the strings to the patient’s face with tape to prevent migration or aspiration of the packing.²⁹