Table 2.
Reported cases of bismuth iodoform paraffin paste (BIPP) toxicity.
| Entry | Gender (Age [Years]) | Surgery | Symptoms after Packing with BIPP | Bismuth Levels | Observations | References |
|---|---|---|---|---|---|---|
| 1 | F (57) | Removal of a basal cell carcinoma | Agitation, confusion, restlessness | 52 ng/L | - | [114] |
| 2 | F (86) | Partial maxillectomy | Exhaustion, lightheadedness, poor appetite, tremor | Day 14: 146 nmol/L Day 22: 81 nmol/L |
- | [115] |
| 3 | F (16) | Myringoplasty | Mild erythema and swelling of the concha | - | Allergic contact otitis externa due to BIPP | [116] |
| F (13) | Myringoplasty | - | - | Allergic contact otitis externa due to BIPP | ||
| F (52) | Myringoplasty | Florid eczematous reaction | - | Allergic contact otitis externa due to BIPP | ||
| 4 | M (81) | Epistaxis treatment with BIPP packing | Acute confusion, dysphagia | 250 µg/L | - | [117] |
| 5 | M (67) | Resection of a sacral chondroma | Acute confusion, disorientation, delusions, aggressive, abdominal discomfort, nausea, tremor | Blood: 240 µg/L Urine: 2800 µg/L |
- | [118] |
| 6 | M (59) | Marsupialisation and packing with BIPP of a keratocystic odontogenic tumor | Fatigue, confusion, apathy, forgetfulness, and spasms in the quadriceps | Blood: 109.9 nmol/L | After 18 months, blood bismuth concentration was 0.02 nmol/L | [119] |
| F (92) | Right hemimaxillectomy | Confusion | Blood: 144.0 nmol/L | After 4 months, blood bismuth concentration was 8.9 nmol/L | ||
| 7 | F (72) | Partial maxillectomy | Confusion, depressed mood, disorientation, aggression, behavioral change | Serum: 391 nmol/L | After 4 months, the serum bismuth concentration was 120 nmol/L | [120] |
| 8 | M (74) | Endoscopic nasopharyngectomy | Agitation, drowsiness, negative myoclonus | Day 7: Urine: 37,094 µg/L |
Day 26—Urine bismuth levels: 457 µg/L Blood bismuth levels were not obtained in the early postoperative period, but were normal (13.6 ng/L) on Day 18 |
[121] |