ABSTRACT
We report a case of silver tattooing of the nasal mucosa in a silver polisher. The concern in such cases is mainly due to the suspicion of melanoma. The diagnosis was confirmed by using the Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS) method, which revealed the presence of two types of silver isotopes, at 107 and 109 m/z.
Subject(s)
Nasal Mucosa/pathology , Nose Diseases/pathology , Occupational Diseases/pathology , Silver , Diagnosis, Differential , Humans , Male , Melanoma/diagnosis , Middle Aged , Nose Diseases/diagnosis , Nose Diseases/etiology , Nose Neoplasms/diagnosis , Occupational Diseases/diagnosis , Occupational Exposure , Silver/adverse effectsABSTRACT
Steroid nose drops are used frequently to treat rhinosinusitis and nasal polyposis. The middle meatal area is of key importance in the pathophysiology of these conditions. This study assesses which of three head positions commonly used to instil nose drops resulted in the highest coverage of this area. Discomfort levels were also studied using a visual analogue scale for each position. Five volunteers were studied in: (i) head back (HB); (ii) head forward and down (HFD); and (iii) lying head back (LHB) positions. Betamethasone nose drops, dyed with fluorescein, were instilled into each nostril and the distribution was studied endoscopically. The middle meatus area distribution was highest in the LHB position (55.51%), followed by HFD (31.55%) and HB (6.87%) positions. Comparison of distribution between HB and LHB (P = 0.002) and between HB and HFD (P = 0.045) was statistically significant. The HFD position was most uncomfortable (mean discomfort score 8.8) whereas the HB (2.4) and LHB (2.6) were similar. The LHB would, therefore, appear to be the most suitable position for instillation of steroid nose drops.
