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Argyremia in septal cauterization with silver nitrate
R C Nguyen1, J E Leclerc, A Nantel
1Département d'ORL, Pavillon CHUL-Centre Hospitalier Universitaire de Québec, Ste-Foy.
The Journal of Otolaryngology
|August 26, 1999
Summary
Silver nitrate cauterization for nosebleeds leads to significant silver absorption in blood, but not hair. This highlights the potential for silver intoxication with overuse.
Area of Science:
- Otolaryngology
- Toxicology
- Analytical Chemistry
Background:
- Nasal cauterization is a common procedure for epistaxis.
- Silver nitrate is frequently used for its hemostatic properties.
Purpose of the Study:
- To assess silver absorption in blood and hair after nasal septal cauterization.
- To evaluate the potential toxicity associated with silver absorption.
Main Methods:
- Prospective study involving 11 volunteers (5 epistaxis patients, 6 healthy).
- Silver nitrate applicators used for cauterization of the nasal septum.
- Blood samples collected pre- and post-cauterization; hair samples collected 3 months later.
- Inductively coupled plasma mass spectrometry (ICP-MS) used for silver concentration analysis.
Main Results:
- Significant increase in whole blood silver concentrations post-cauterization (p = .02).
- Peak blood silver levels correlated with the number of silver nitrate applicators used.
- No significant silver concentration increase detected in hair samples.
Conclusions:
- Silver absorption into the bloodstream is confirmed after nasal cauterization.
- Hair analysis is unreliable for documenting acute or recent silver exposure.
- Indiscriminate use of silver nitrate poses a risk of silver intoxication.