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Silver nitrate cauterisation, does concentration matter?

2007; Wiley; Volume: 32; Issue: 3 Linguagem: Inglês

10.1111/j.1365-2273.2007.01409.x

1749-4486

Mohamed Amin, Fergal Glynn, Susan Phelan, Patrick Sheahan, P. Crotty, D. McShane,

Nasal Surgery and Airway Studies

Keypoints • Epistaxis from the anterior septum is frequently treated with a topical application of silver nitrate. There are two concentrations commercially available and in use by otolaryngologists, these are 75% and 95% silver nitrate. The purpose of the present study was to investigate the histological effect of the two different silver nitrate concentrations on mucosal tissue at a fixed contact time of 5 s. • Twelve children undergoing routine tonsillectomy were included in this study. Prominent blood vessels on the mucosal surface of the tonsils were identified and a single vessel on each tonsil was selected for application of either 75% or 95% concentration of silver nitrate for 5 s. • Depth of penetration across the tonsil tissue was measured following application of the two different silver nitrate concentrations. • This study demonstrated a significant difference in depth of tissue penetration with the 95% averaging a twofold increase in penetration depth. • It is likely that the increased depth of penetration with 95% silver nitrate may increase the risk of complication of nasal cautery such as septal perforation, particularly in patients undergoing repeated or bilateral nasal cautery.