Latex allergy - An update the otolaryngologist

Objective: To describe the clinical manifestations of latex allergy in otol aryngology patients. Design: Descriptive case series. Setting: Tertiary academic otolaryngology practice. Patients: Otolaryngology patients with documented allergic reactions to lat ex during surgery and confirmatory laboratory test results for latex allerg y. Main Outcome Measures: Clinical description of latex reactions; identificat ion of risk factors for latex allergy. Results: We describe 3 patients, 2 children and 1 young adult, with severe latex allergy manifested by intraoperative cardiorespiratory changes and co nfirmed by positive latex-specific IgE test results. A 9-year-old boy with a tracheotomy and a history of multiple procedures for laryngeal stenosis d eveloped a rash and unexplained bronchospasm during an open laryngeal proce dure. Surgery was aborted, and subsequent surgery was performed uneventfull y 4 weeks later using a latex-safe environment. A 13-year-old boy with recu rrent respiratory papillomatosis and a ventriculoperitoneal shunt had sudde n unexplained arterial oxygen desaturation and a rash during laser endoscop y. Ile was then treated successfully using latex-safe protocols. A 23-year- old man with a parotid malignancy developed unexplained hypotension and ven tilatory difficulties in the ope rating room during preparation for surgery . He responded to medical treatment for anaphylaxis. Conclusion: The otolaryngologist should share in the increased awareness of latex allergy. Our patients who have had multiple surgical procedures or w ho are exposed to latex on a long-term basis may be at increased risk. Late x allergy should be considered when unexplained cardiorespiratory compromis e occurs during surgery.