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Bismuth iodoform paraffin paste hypersensitivity reactions in mastoid cavities following isolation of mucosal lining: a series of 587 patients

Published online by Cambridge University Press:  11 January 2012

C J Coulson ,
D D Pothier ,
P Lai  and
J A Rutka
C J Coulson*
Affiliation:
Department of Otolaryngology, Division of Otology/Neurotology, Toronto General Hospital, Ontario, Canada
D D Pothier
Affiliation:
Department of Otolaryngology, Division of Otology/Neurotology, Toronto General Hospital, Ontario, Canada
P Lai
Affiliation:
Department of Otolaryngology, Division of Otology/Neurotology, Toronto General Hospital, Ontario, Canada
J A Rutka
Affiliation:
Department of Otolaryngology, Division of Otology/Neurotology, Toronto General Hospital, Ontario, Canada
*
Address for correspondence: Dr C Coulson, Department of Otolaryngology, Division of Otology/Neurotology, Toronto General Hospital, 7N – 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada Fax: +1416 340 3327 E-mail: chriscoulson1@gmail.com
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Abstract

Aim:

(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).

Materials and methods:

All patients undergoing canal wall down mastoidectomy with intra-operative bismuth iodoform paraffin paste packing between 1985 and 2009 were identified and reviewed.

Results:

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.

Conclusion:

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.

Keywords

MastoidectomyCholesteatomaDressingsHypersensitivityComplications
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 3 , March 2012 , pp. 240 - 243
Copyright
Copyright © JLO (1984) Limited 2012

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