Nickel carcinogenesis of the respiratory tract

The role of some nickel compounds and other chemical carcinogens in the causation of cancer of the nose and paranasal sinuses must be recognized. Preventive health measures taken by the nickel industry to eliminate the hazard of nickel carcinogenesis have included improved worker hygiene, reduction of refinery dusts and aerosols, and a strict monitoring of employees by regular examination and plasma nickel testing. The treatment of carcinoma limited to the naso-antral wall or ethmoid labyrinth by an en bloc resection is described, as well as the management of cribriform plate CSF leaks sometimes associated with the ethmoid resection. A subcutaneous cheek flap from the lateral rhinotomy is reflected inward against the cribriform plate to control cerebrospinal fluid rhinorrhea.