Coulson C J, Pothier D D, Lai P, Rutka J A
Department of Otolaryngology, Division of Otology/Neurotology, Toronto General Hospital, Ontario, Canada.
J Laryngol Otol. 2012 Mar;126(3):240-3. doi: 10.1017/S0022215111003306. Epub 2012 Jan 11.
(1) To assess hypersensitivity to bismuth iodoform paraffin paste impregnated ribbon gauze following its use in packing canal wall down mastoidectomy cavities; (2) to determine if isolation of the skin and mucosa from the pack, using thin Silastic sheeting and Cortisporin ointment, reduces hypersensitivity reactions, compared with a previous series; and (3) to review the literature and to determine if bismuth iodoform paraffin paste hypersensitivity precludes the consumption of seafood (due to its high iodine content).
All patients undergoing canal wall down mastoidectomy with intra-operative bismuth iodoform paraffin paste packing between 1985 and 2009 were identified and reviewed.
Of 587 patients identified, the overall bismuth iodoform paraffin paste reaction rate was 1 per cent. All reactions were in patients undergoing revision mastoidectomy procedures, giving a reaction rate for revision procedures of 2.4 per cent.
Reactions are an uncommon event following post-operative mastoid cavity packing using bismuth iodoform paraffin paste. Reaction rates may be lowered by preparing the cavity with Silastic sheeting and Cortisporin ointment prior to packing, thus isolating the skin and mucosal surfaces. Development of such a reaction does not preclude the consumption of seafood.
(1)评估碘仿铋石蜡糊浸渍带状纱布用于填充开放式乳突切除腔后出现超敏反应的情况;(2)与之前的系列研究相比,确定使用薄硅橡胶片和可的松眼膏将皮肤和黏膜与填充物隔离是否能减少超敏反应;(3)查阅文献,确定碘仿铋石蜡糊超敏反应是否会因海鲜碘含量高而限制海鲜食用。
确定并回顾了1985年至2009年间所有接受开放式乳突切除术并在术中使用碘仿铋石蜡糊填充的患者。
在确定的587例患者中,碘仿铋石蜡糊的总体反应率为1%。所有反应均发生在接受乳突改良根治术的患者中,改良根治术的反应率为2.4%。
术后使用碘仿铋石蜡糊填充乳突腔后发生反应是罕见事件。在填充前用硅橡胶片和可的松眼膏处理术腔以隔离皮肤和黏膜表面,可能会降低反应率。发生这种反应并不限制海鲜食用。