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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: [email protected]
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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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References

1Lim, PV, Hughes, RG, Oates, J. Hypersensitive allergic reactions to bismuth-iodoform-paraffin paste following ear surgery. J Laryngol Otol 1998;112:335–7CrossRefGoogle ScholarPubMed
2Morrison, R. The treatment of infected suppurating war wounds. Lancet 1916;188:268–72CrossRefGoogle Scholar
3Chambers, H, Goldsmith, JN. The bacteriological and chemical action of bismuth-iodoform-paraffin paste. Lancet 1917;189:333–5CrossRefGoogle Scholar
4Nigamy, A, Allwood, MC. BIPP – how does it work? Clin Otolaryngol 1990;15:173–5CrossRefGoogle Scholar
5Colman, G. A study of some antimicrobial agents used in oral surgery. Br Dent J 1962;113:22–8Google Scholar
6Chevretton, EB, McRae, RDR, Booth, JB. Mastoidectomy packs: Xeroform or BIPP? J Laryngol Otol 1991;105:916–17CrossRefGoogle ScholarPubMed
7Radden, HG. Mouth wounds. Br Dent J 1962;113:112–19Google Scholar
8Farrell, RW. Dangers of bismuth iodoform paraffin paste. Lancet 1994;344:1637–8CrossRefGoogle ScholarPubMed
9Bennett, AMD, Bartle, J, Yung, MW. Avoidance of BIPP allergy hypersensitivity reactions following ear surgery. Clin Otolaryngol 2008;33:32–55CrossRefGoogle ScholarPubMed
10Sharma, RR, Cast, IP, Redfern, RM, O'Brien, C. Extradural application of bismuth iodoform paraffin paste causing relapsing bismuth encephalopathy: a case report with CT and MRI studies. J Neurol Neurosurg Psychiatry 1994;57:990–3CrossRefGoogle ScholarPubMed
11Daul, CB, Morgan, JE, Lehrer, SB. Hypersensitivity reactions to crustacea and mollusks. Clin Rev Allergy 1993:11:201–22CrossRefGoogle ScholarPubMed
12Coakley, FV, Panicek, DM. Iodine allergy: an oyster without a pearl? AJR Am J Roentgenol 1997;169:951–2CrossRefGoogle ScholarPubMed