Sandwich graft technique outcomes in medium and large size nasal septal perforations / Resultados da técnica de enxerto sanduíche em perfurações do septo nasal de médio e grande porte

Abstract Introduction: Surgical treatment of medium and large sized nasal septal perforation is challenging. Techniques with and without interposition grafts are used. Objective: The aim of this study is to explain how we apply the sandwich graft technique that we use in medium and large nasal septal perforations as well as to present the results. Methods: We retrospectively reviewed the patients who were operated with the sandwich graft technique between January 2014 to December 2018 and followed up for at least 6 months. The demographic data, symptom scores, examination, and surgical findings of the patients were taken from the hospital records. Surgical outcomes were presented according to both perforation etiologies (idiopathic or iatrogenic) and sizes (Group A: < 2cm, Group B: ≥ 2 cm). Results: We reviewed 52 cases and 56 surgeries. The average diameter of the perforations was 19.2 mm. The success rate after initial surgeries was 84.6% (44/52). After 4 revision surgeries, the perforation was closed in 88.5% of the cases (46/52). Success rates for Group A and Group B were 90.0% and 86.4%, respectively (p = 0.689). The success rates in idiopathic and iatrogenic cases were 93.3% and 86.5%, respectively (p = 0.659). Conclusion: This study showed that the success rate of sandwich graft technique was higher in medium-sized perforations than large-sized ones and in idiopathic perforations compared to iatrogenic ones, but the latter rate was not statistically significant. This demonstrated that perforation size was not as important in the sandwich graft technique as in flap techniques.

Resumo Introdução: O tratamento cirúrgico da perfuração do septo nasal de médio e grande porte ainda é um desafio. Várias técnicas são usadas, com e sem enxertos de interposição. Objetivo: Descrever o uso da técnica de enxerto sanduíche que usamos nas perfurações de septo nasal de médio e grande porte e apresentar os resultados. Método: Revisamos retrospectivamente os prontuários de pacientes que foram operados com a técnica de enxerto sanduíche entre janeiro de 2014 e dezembro de 2018, com acompanhamento por pelo menos seis meses. Os dados demográficos, escores de sintomas, exames e achados cirúrgicos dos pacientes foram extraídos dos registros hospitalares. Os resultados cirúrgicos foram apresentados de acordo com as etiologias (idiopática ou iatrogênica) e os tamanhos da perfuração (Grupo A: < 2cm, Grupo B: >2cm). Resultados: Revisamos 52 casos e 56 cirurgias. O diâmetro médio das perfurações foi de 19,2 mm. A taxa de sucesso após as cirurgias iniciais foi de 84,6% (44/52). Após quatro cirurgias de revisão, a perfuração foi fechada em 88,5% dos casos (46/52). As taxas de sucesso para os Grupos A e B foram, respectivamente, 90,0% e 86,4% (p = 0,689). As taxas de sucesso nos casos idiopáticos e iatrogênicos foram, respectivamente, 93,3% e 86,5% (p = 0,659). Conclusão: Este estudo mostrou que a taxa de sucesso da técnica de enxerto sanduíche foi maior nas perfurações de médio porte do que nas de grande porte e nas perfurações idiopáticas do que nas iatrogênicas, mas sem significância estatística. Esse dado demonstrou que o tamanho da perfuração não foi tão importante na técnica de enxerto sanduíche quanto nas técnicas com uso de retalho.

Rapid hemostasis: a novel and effective outpatient procedure using microwave ablation to control epistaxis of isolated mucosal bulge lesions / Hemostasia rápida: um procedimento ambulatorial novo e eficaz utilizando ablação por micro-ondas para controlar a epistaxe de lesões isoladas protuberantes da mucosa

Abstract Introduction Recurrent epistaxis is commonly encountered in the rhinology outpatient clinic. Under endoscopic guidance, both bipolar cautery and monopolar forceps (combined with suction) have been employed to control the bleeding. However, the use of monopolar forceps requires the placement of grounding pads. Most procedures are currently performed in operating rooms. Objective We investigated outcomes after the use of Microwave Ablation (MWA) to control epistaxis in adults with isolated mucosal bulge lesions. All procedures were performed with patients under local anesthesia in our outpatient clinic. Methods This is a retrospective cohort study. We included 83 adults with epistaxis of isolated mucosal bulge lesions. Microwave ablation was performed in the outpatient clinic to control bleeding, after induction of local anesthesia. The primary outcome was successful hemostasis. The secondary outcomes were the rebleeding rates at weeks 1 and 4 and month 6, and complications (crust or synechiae formation, septal perforation, and/or orbit or brain complications). Results All bleeding points were successfully ablated; hemostasis was achieved within 1-2 min. The mean pain score was 1.83 intra-operatively and 0.95 1 h postoperatively. No patient re-bled, and no severe MWA-related complication (septal perforation, synechiae formation, or orbit or brain complication) was recorded to 6 months of follow-up. Conclusions Endoscopic microwave ablation with patients under local anesthesia is a novel, safe, effective, rapid, well-tolerated, outpatient treatment for adults with epistaxis of isolated mucosal bulge lesions, especially those for whom general anesthesia might be risky, those with electrical implants, and those exhibiting contraindications for arterial embolization.

Resumo Introdução Epistaxe recorrente é comumente encontrada no ambulatório de rinologia. Sob orientação endoscópica, foram empregados tanto o cautério bipolar quanto a pinça monopolar (combinados à sucção) para controlar a condição. No entanto, o uso de pinças monopolares requer a colocação de placas de aterramento. Atualmente, a maioria dos procedimentos é feita em salas de cirurgia. Objetivo Investigamos os resultados após o uso da ablação por micro-ondas (MWA, do inglês Microwave Ablation) no controle da epistaxe em adultos com lesões isoladas protuberantes da mucosa. Todos os procedimentos foram feitos em nosso ambulatório com os pacientes sob anestesia local. Métodos Estudo de coorte retrospectivo. Foram incluídos 83 adultos com epistaxe de lesões isoladas protuberantes da mucosa. A ablação por micro-ondas foi feita no ambulatório para controlar o sangramento, após a administração de anestesia local. O desfecho primário foi uma hemostasia bem-sucedida. Os desfechos secundários foram as taxas de ressangramento, nas semanas 1 e 4 e no mês 6, e complicações (formação de crostas ou sinéquias, perfuração septal e/ou complicações orbitais ou cerebrais). Resultados Todos os pontos de sangramento foram contidos com sucesso; a hemostasia foi alcançada em 1-2 minutos. O escore médio de dor foi de 1,83 no intraoperatório e de 0,95 1 h no pós-operatório. Nenhum paciente apresentou ressangramento e nenhuma complicação grave relacionada à MWA (perfuração septal, formação de sinéquias ou complicações orbitais ou cerebrais) foi registrada em 6 meses de seguimento. Conclusões A ablação endoscópica por micro-ondas com pacientes sob anestesia local é um tratamento ambulatorial novo, seguro, eficaz, rápido e bem tolerado para adultos com epistaxe de lesões isoladas protuberantes da mucosa, especialmente aqueles para os quais a anestesia geral pode ser arriscada, indivíduos com implantes elétricos e aqueles com contraindicações para embolização arterial.

Resultados posoperatorios de cierre quirúrgico de perforación septal con injertos de cartílago / Surgical outcomes of nasal septal perforation repair with cartilage grafts

Introducción: las perforaciones septales y su corrección quirúrgica constituyen un reto para los otorrinolaringólogos. En la literatura se describen diferentes técnicas para el cierre de las perforaciones septales; sin embargo, sus resultados en términos de efectividad son muy variables y con pocos pacientes. Desde hace 8 años se viene realizando la técnica de cierre de perforación septal con injertos de cartílago en el servicio de otorrinolaringología del Hospital de San José, y se ha observado una respuesta clínica exitosa. El objetivo del presente estudio fue describir los resultados posoperatorios de los pacientes manejados con la técnica de cierre quirúrgico de perforación septal con injertos de cartílago, en términos de aparición de complicaciones y frecuencia de perforación septal residual. Materiales y métodos: mediante un estudio de cohorte descriptiva se presentan los pacientes manejados con la técnica de cierre quirúrgico de perforación septal con injertos de cartílago de banco o cartílago autólogo. Se incluyen pacientes a partir enero de 2014 a junio 2018. De la historia clínica se extrajeron los datos demográficos, clínicos, complicaciones y presentación de perforación septal residual. Resultados: la tasa de éxito de cierre de perforación septal fue de 78,3 %; siendo las etiologías más frecuentes antecedente de cirugía e idiopática. La complicación más común fue epistaxis en el 26 % de los pacientes, seguida de dolor en el 21,7 % en el posoperatorio mediato, el cual mejoró en los controles posteriores. Conclusión: los resultados con la técnica de cierre de perforación septal con injerto de banco fueron satisfactorios en esta población.

Introduction: septal perforations and surgical correction are a challenge for ENT specialists. Several techniques for closing septal perforations are described in the literature; however, its results in terms of effectiveness are variable and with small sample sizes. The technique of closure of septal perforation with cartilage grafts has been performed for 8 years in the ENT department of Hospital de San José with a successful clinical response. Aims: to describe the postoperative results of patients managed with the technique of surgical closure of septal perforation with cartilage grafts, in terms of complications and frequency of residual septal perforation. Design: descriptive cohort study. Methods: a cohort of patients managed with the surgical closure technique of septal perforation with grafts of bank cartilage or autologous cartilage are described. Patients were included from January 2014 to June 2018. Demographic, clinical data, complications and presentation of residual septal perforation were extracted from the clinical history. Results: The success rate of septal perforation closure was 78.3 %; being the most frequent etiologies antecedent of surgery and idiopathic. The most common complication was epistaxis in 26 % of patients, followed by pain in 21.7 % in the postoperative period, which improved in subsequent controls. Conclusion: the results with the technique of closure of septal perforation with bank grafting were satisfactory in this population.

Two Cases of Septal Perforation Repair using Posterior Margin Based Hinge Flap

Nasal septal perforation is a defect of cartilage, bone, or mucosa of the nasal septum. Nasal septal perforation has several potential causes such as previous septal surgeries, trauma, malignancy, inflammation, or drugs. According to previous studies, successful surgical outcome is affected by the size and location of the perforation. Although many surgical techniques have been reported, there is no standardized nor consistent surgical method for repairing nasal septal perforation. This report suggests a new surgical technique of repairing septal perforation using a posterior perforation-margin-based hinge flap.

A Securing Suture Technique of Autologous Cartilage for the Prevention of Septal Perforation during Septal Surgery

BACKGROUND AND OBJECTIVES: Septoplasty is a commonly performed operation in otolaryngological practice. In cases of septal mucosal tearing, septal perforation can easily occur. The aim of this study was to investigate patients who underwent an autologous cartilage securing suture technique to prevent nasal septal perforation. SUBJECTS AND METHODS: A total of 403 patients who underwent septoplasty alone or with endoscopic sinus surgery for the past three years were enrolled in this study. Septal mucosal tearing occurred in 27 patients. In group 1 (15 patients), autologous cartilage was inserted between the injured mucosa. In group 2 (12 patients), autologous cartilage was inserted between the injured mucosa with a securing suture technique. We investigated the septal perforation rate between the two groups. RESULTS: In group 1, septal perforation occurred in 7 of 15 patients (46.6%) and in group 2 there were no perforations. The occurrence rate of perforation in group 2 was significantly lower than that in group 1 (p<0.01). CONCLUSION: The securing suture technique of autologous cartilage can be an effective method for prevention of septal perforation during septal surgery.

Assessment of mucosal changes associated with nasal splint in a rabbit model / Avaliação sobre alterações na mucosa, associadas ao uso de splints nasais, utilizando coelhos como cobaias

INTRODUCTION: There is no consensus on duration of the nasal splint after nasal septum surgeries. The pressure of nasal splint on the mucosa may cause tissue necrosis and nasal septum perforation. OBJECTIVES: To investigate the histopathological changes of the nasal mucosa caused by nasal splints in a rabbit model. METHODS: No splint was used in group A. Bilateral silicone nasal splints were placed for five, ten, and 15 days in groups B, C, and D, respectively. Biopsy of the nasal mucosa was performed after removal of splint. Histopathologic evaluations were performed. The severity and depth of the inflammation were scored. RESULTS: Group A had a normal histological appearance. Comparison of the results of groups B, C, and D with group A demonstrated statistically significant differences with regards to the severity of histopathological findings. There was no statistically significant difference between groups B and C. There were statistically significant differences between the groups B and D, and also between groups C and D. CONCLUSIONS: Longer duration of nasal splint had a higher risk for septal perforation. Therefore, removal of the splint as soon as possible may be helpful for preventing potential perforations. .

INTRODUÇÃO: Não existe consenso acerca do tempo de permanência de splints nasais no pós-operatório de cirurgias no septo. A pressão causada pelos mesmos na mucosa nasal pode causar necrose e perfurações septais. OBJETIVOS: Investigar mudanças histopatológicas da mucosa nasal causadas por splints nasais em coelhos. MÉTODO: Nenhum splint foi utilizado no grupo A. Splints de silicone foram utilizados por 5, 10 e 15 dias nos grupos B, C e D, respectivamente. Biópsia da mucosa nasal foi realizada após a remoção dos mesmos. Avaliações histopatológicas foram realizadas, e a gravidade e a profundidade do processo inflamatório foram medidas. RESULTADOS: Grupo A apresentou uma aparência histológica normal. Comparações de resultados entre os grupos B, C e D com o grupo A demonstraram diferenças estatísticas relevantes na gravidade histopatológica. Não houve diferenças estatísticas relevantes entre os grupos B e D, assim como entre os grupos C e D. CONCLUSÃO: De acordo com os resultados, quanto maior a duração no uso de splints nasais maior o risco de perfuração septal. Portanto, a remoção de splints nasais deve ser realizada assim que possível, prevenindo potenciais perfurações. .

Two Cases of Unilateral Nasoseptal Pedicled Rotational Mucosal Flap and Interpositional Dermal Allograft for Septal Perforations / 대한이비인후과학회지

A nasoseptal perforation is a defect of cartilage, bone, and mucosa of nasal septum, caused by nasal surgery, malignancy, inflammation, or drugs. Although various surgical treatments and procedures are well known, there is no consensus on the procedures due to low success rate (25-90%) and high recurrence rate (12-48%). One of the major factors that affect surgical results is the size of perforation. For large perforations, the surgical success rate is reported to range from 23% to 70%. The authors report two successful cases of repair surgery of nasoseptal perforation, using unilateral pedicled nasoseptal rotational mucosal flap with releasing incision and interpositional dermal allograft. Although larger study populations and long-term follow-up periods are needed, the authors believe that our method is an effective way to minimalize possible inconveniences observed in the cases of comparatively large perforations, or where there is a lack of autografts or donor site defects.

A case series of button batteries as nasal foreign bodies among children.

Foreign bodies are a common occurrence in children that may be either accidental or self-induced as a matter of habit. Various materials have been reported as foreign bodies like metal, plastic toy parts, food matters, etc. Button batteries have been reported as foreign bodies in the nose and are especially relevant, due to their early chemical disintegration in contact with mucosal surface; hence, need emergency surgical intervention to avoid complications like septal necrosis and perforation. Here, we report four cases of button batteries in the nose at various stages of presentation with their sequelae along with a review of literature.

Sandwich Graft using Ear Cartilage and Inferior Turbinate Mucoperiosteal Free Graft Via Open Rhinoplasty Approach for Repair of Nasal Septal Perforation

Repair of nasal septal perforation is a challenging problem to surgeons. Many surgical techniques which were reported through many literatures did not show high success rate constantly. The aim of this study was to examine the surgical technique of sandwich graft using inferior turbinate mucoperiosteal free graft and ear cartilage via open rhinoplasty approach. MATERIAL & METHODS: From May 2008 to December 2010, 7 patients who were suffered from nasal septal perforation underwent sandwich graft using ear cartilage and inferior turbinate mucoperiosteal free graft via open rhinoplasty approach. RESULTS: Mean age was 45+/-10.1 years (28~60 years old). We followed up 7 patients for 2 months after the surgery. Six of the 7 patients had a complete closure and one patient achieved incomplete closure. One patient who had incomplete closure was treated by primary closure again. CONCLUSIONS: Sandwich graft of inferior turbinate mucoperiosteal free graft and ear cartilage via open rhinoplasty approach showed high success rate and relatively easy surgical technique.

Prosthetic rehabilitation of large nasal septal defect with an intranasal stent: A clinical report.

Nasal septal perforation is a common complication of many nasal diseases such as congenital, infectious, trauma, and iatrogenic, and rarely may occur as a complication of systemic diseases, etc. The symptoms of uncorrected nasal septal perforations include crusting, epistaxis, difficulty in breathing, nasal twang in speech, postnasal discharge, foul-smelling, rhinorrhea, and hyposmia. Large nasal defects cannot be closed by hard acrylic resin nasal septal obturators because of the problems in access and path of insertion. However, obturation can be achieved by fabrication of a nasal stent that engages one of the nasal cavities. This clinical report describes prosthetic management of a patient with large nasal septal defect following septal surgery complication with an intranasal heat-processed acrylic resin stent. The stent is rendered patent for comfortable breathing, improves speech, is esthetically acceptable, dense and hygienic. These nasal stents indirectly separate the two nasal cavities with effective obturation of large nasal septal defects.

Usefulness of Autologous Cartilage and Fibrin Glue for the Prevention of Septal Perforation during Septal Surgery: A Preliminary Report / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Septal surgery is one of the common causes of nasal septal perforation. In cases of bilateral septal mucosal tearings, autologous cartilage is usually inserted between the injured mucosa. Additionally, we applied the fibrin glue on the margin of injured mucosal surface for the fixation of inserted cartilage and for the promotion of mucosal regeneration. The aim of this study was to evaluate the efficacy of this method in the prevention of nasal septal perforation. SUBJECTS AND METHOD: A total 378 cases of septal surgery was performed during past 2 years. Bilateral septal mucosal injuries at the corresponding area occurred in 32 patients. In group 1 (23 patients), autologous cartilage was inserted between the injured mucosa. In group 2 (9 patients), autologous cartilage was inserted and fibrin glue was applied on the mucosal margin of cartilage insertion site. We compared the perforation rate between two groups. RESULTS: In group 1, nasal septal perforation occurred 8 of 23 patients (34.7%) and in group 2, 1 of the 9 patients (11.1%) had perforation. Although the occurrence rate of perforation was significantly lower in group 2, statistical significance between two groups were absent because of the small number of patients who experienced the septal perforation. CONCLUSION: The application of fibrin glue after cartilage insertion at the defect site is thought to be very useful in the prevention of nasal septal perforation. We report these results as a preliminary data for the future study about the usefulness of fibrin glue in the prevention of nasal septal perforation.

Nasal Septal Perforation due to Button Battery

A button battery in the nose of children is an unusual foreign body, which can cause liquefaction necrosis with subsequent severe local tissue destruction. All button batteries as foreign bodies in the nasal cavity should be removed immediately to prevent severe local tissue damage, resulting in late sequelae, such as septal perforation or stenosis of the nasal meatus. We present two cases of nasal septal perforation followed by button battery foreign body and discuss the special aspects of this foreign body.

Nasal Septal Perforation due to Button Battery

A button battery in the nose of children is an unusual foreign body, which can cause liquefaction necrosis with subsequent severe local tissue destruction. All button batteries as foreign bodies in the nasal cavity should be removed immediately to prevent severe local tissue damage, resulting in late sequelae, such as septal perforation or stenosis of the nasal meatus. We present two cases of nasal septal perforation followed by button battery foreign body and discuss the special aspects of this foreign body.

Olfactory Function in Chromium Exposed Workers Without Nasal Septum Perforation / 대한산업의학회지

OBJECTIVES: The chrome-induced olfactory alterations is caused by inhalation of chromic acid, a highly corrossive and toxic materials. And nasal septum perforation(NSP) has been suspected with possible causative factor of olfactory alterations. To our knowledge, there has been no report of the detailed findings of the olfactory alterations in chrome exposed subjects without nasal septum perforation(NSP). So we present the results of olfactory function test measured by T&T olfactometer and olfactometer perception test among chromium exposed workers without NSP. METHODS: We performed this study in 25 study subjects and 25 control subjects matched with age, alcohol and smoking. All of subjects are man. We performed olfactory function test measured by T&T olfactometer and olfactometer perception test. RESULTS: 1) The age distribution of the subjects involved in this study was from 20 to 54 years old (average 33.3 years old) and the mean duration exposed to chromium was from 64. 9 months. 2) The olfactory function was checked by detection and recognition thresholds in five odorants. The detection thresholds of exposed group dealing with chromium were significantly increased in A and B ordorants than nonexposed group. The recognition thresholds of exposed group were significantly increased in D ordorants than nonexposed group. 3) The mean threshold of olfactometer perception test of exposed group were more increased than nonexposed group. But thresholds difference did not show statistical significance, 4) The detection thresholds of A and D ordorants, recognition threshold of C ordorants and thresholds of olfactometer perception test were increased in the relation with duration of chrome exposure. CONCLUSIONS: There has been no remarkable alterations in olfactory sense (TkT olfactometer and Olfactometer Perception Test) in subjects without nasal septum perforation(NSP) exposed to chromic acid.

Reconstruction of Septal Perforation with Alloderm / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The closure of nasal septal perforation is a significant surgical challenge with high failure rates. Acellular human dermal graft (Alloderm) placed between mucoperichondrial advancement flaps may be an alternative. The purpose of this study was to investigate the usefulness of Alloderm for the repair of nasal septal perforation. MATERIALS AND METHODS: Seven consecutive patients with septal perforation who received the septal perforation repair with Alloderm were included in this study. The causes of septal perforations were previous nasal surgeries, trauma, chemical irritation, inflammation, or unknown. Follow-up periods ranged from 7 to 36 months. RESULTS: Six of seven patients had successful outcomes with complete closure of their perforations. The remaining one patient had an incomplete closure, but the size of the performation was reduced with no further symptoms. CONCLUSION: AIloderm can be used as a connective tissue and interpositional grafts in the repair of septal perforations with high success rates. Therefore, Alloderm is the viable alternative for the closure of nasal septal perforations.

A Study of Working Environments and Workers Exposed to Chromium / 예방의학회지

For the purpose of providing the basic data for health management of workers who are exposed to chromium and for improving the quality of working environment, the authors evaluated blood and urinary level of chromium, the occupational history, AST, ALT, Hb, Hct, nasal specular examination on 287 workers who have been dealed chromium compounds in 56 manufacturing industries of five types, that is, 38 metal plating services(plating), 4 manufacture of other fabricated metal products (fabricated metal product), 5 manufacturing of dyestuff(dyestuff), 6 dressing and dyeing of leather (leather), 3 others (manufacture of pottery and ceramic household wares, motor vehicles, electronic valves and tubes and other electronic components) and also measured the level of chromium in air from February to october 1993. The results were as follows; 1. The utilized type of chromium compounds was the hexavalent state in plating, fabricated metal product, dyestuff leather and the trivalent state in other, and atmospheric chromium concentration as geometric mean was 0.0138m3(0.001~0.068 mg/m3) in plating, 0.0115 mg/m3(0.006~0.015 mg/m3) in fabricated metal product, 0.068 mg/m3 (0.002~0.019 mg/m3)in dyestuff, 0.0083 mg/m3(0.002~0.028 mg/m3) in leather, 0.0039 mg/m3(0.003~0.005 mg/m3) in other by the type of industry and it exceeded TLV-TWA (0.05 mg/m3) in five(13.6%) of plating services. 2. The geometric mean of chromium in blood was 1.54 microgram/dl(0.10~3.62 microgram/dl) in planting, 0.94 microgram/dl(0.27~2.82 microgram/dl) in fabricated metal product, 0.51 microgram/dl(0.10~3.25 microgram/dl) in dyestuff, 0.87 microgram/dl(0.15~8.00 microgram/dl) in leather 0.55 microgram/dl(0.20~2.28 microgram/dl) in other by the type of industry(P<0.001). 3. The geometric mean of chromiurn in urine was 14.47 microgram/l(6.90~28.00 microgram/l) in planting, 4.63 microgram/l(0.24~43.00 microgram/l) in fabricated metal product, 5.93 microgram/l(1.00~33.00 microgram/l) in dyestuff. 11.09 microgram/l(0.80~48.00 microgram/l) in leather, 12.41 microgram/l(10.10~41.00 microgram/l) in other by the type of industry(P<0.001). 4 As the result of nasal specular examination, twenty four cases(8.4%) of nasal septal perforation among 287 total subjects was observed, and there were 17(9.7%) cases in plating, 4 cases(14.3%) in dressing and dyeing of leather. In the comparison of chromium concentration in blood and urine between the perforated group and nonperforated group the perforated group showed a significantly higher value as 1.883+/-3.055 microgram/dl and 0.793+/-0.815 microgram/dl(P<0.001). 21.31+/-34.610 microgram/L and 9.304+/-11.079 microgram/L(P<0.001). 5. The mean concentration of chromium in blood, urine and the mean level of AST, ALT, Hb and Hct in exposure group were higher than those of control group(P<0.001).

Health Hazards of Plating Workers / 대한산업의학회지

Chromic acid has widely been used for decorative chromium plating, hard chromium plating, and surface treatment of raw materials. However, its strong oxidizing action has been found to cause corrosion of mucous membranes and skin, such as the nasal septum, conjunctiva, face, and hand skin. Excessive exposure to chmmic acid has frequently caused ulceration and perforation of a nasal septum. These ulcerations are painless and confined to the cartilaginous portion at the lower anterior part of the septum known as Kisselbach's or Little's area. This study was undertaken to investigate the general characteristics, actual conditions of the working environment and the prevalence rate of nasal septal perforation due to inhalation of chromic acid mist in workers employed at plating industries. This study was conducted on 627 workers who were exposed to chromic acid from July to November 1988. The results were summarized as follows: 1. The mean age of workers with septal perforation was 26 years and the mean working duration was 84 months. 2. The prevalence rates of nasal septal perforation and ulceration of mucosa of the plating workers were 31.7% and 10.5% respectively. 3. The significant variables related with occurrence of nasal septal perforation were age of workers, working duration, kinds of plating, efficiency of local ventilation and performance of health examinations. From the above results, occurrences of nasal septal perforation in plating workers were affected by the duration of chromium exposed work and state of the working environment. Prevention of occupationsl diseases fri plating workers will be accomplished by implementation of an industrial health care system which includes thorough health checkups for workers and regular environmental monitoring.