Awake Steroid Injection for Idiopathic Subglottic Stenosis
Video Type: CVideo- 2-5 min videos of a particular surgery or technique. These again show major events in the surgery
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Author: Manvinder Kumar
Published:
Specialties: Otolaryngology
Schools: Emory School of Medicine, University of Southern California
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Loading...Contributor: Michael Johns III, MD
This video demonstrates a steroid injection in an awake patient for the treatment of idiopathic subglottic stenosis. The patient is first anesthetized with topical 2% lidocaine over the larynx and 1% lidocaine with epinephrine percutaneously over the cricoid cartilage. An endoscope is passed transnasally and positioned just below the vocal folds. A 23 gauge needle is then passed through the cricothyroid membrane, and Kenalog is circumferentially injected submucosally taking care not to reduce the caliber size of the airway.
Procedure
Awake Office-Based Corticosteroid Injection for Subglottic Stenosis
Indications
Subglottic Stenosis
Contraindications
Critically narrow airway
Instrumentation
Setup
Topical laryngeal and tracheal anesthesia; Topical nasal anesthesia and decongestant, Transnasal flexible video endoscopy, Subcutaneous injection of lidocaine over the cricothyroid membrane
Preoperative Workup
Diagnostic tracheoscopy/bronchoscopy
Anatomy and Landmarks
Cricothyroid membrane
Advantages/Disadvantages
Advantages: Awake/unsedated
Disadvantages: Delayed effect of treatment
Complications/Risks
Small risk of airway narrowing
Disclosure of Conflicts
None
Acknowledgements
References
Franco RA, Paddle P, Hussain I, Reder L Serial Intra-Lesional Steroid Injections as a Treatment for Idiopathic Subglottic Stenosis. Presented at the 2016 American Laryngological Association Meeting, April 23rd 2015, Boston, MA
http://www.alahns.org/i4a/pages/index.cfm?pageid=3550
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