Assessment of side effects after serial intralesional steroid injections for idiopathic subglottic stenosis
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LARYNGOLOGY
Assessment of side effects after serial intralesional steroid injections for idiopathic subglottic stenosis Ozlem Onerci Celebi1,2 · Sungjin A. Song2,3 · Alena Santeerapharp4 · Kanittha Choksawad5 · Ramon A. Franco Jr2,3,6 Received: 24 August 2020 / Accepted: 10 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To assess the incidence and severity of 12 systemic side effects of serial intralesional steroid injections (SILSI) in patients with idiopathic subglottic stenosis (iSGS). Methods This retrospective study included patients with iSGS who underwent SILSI with Triamcinolone 40 mg/dL. After SILSI, the patients were asked to answer 12 questions regarding frequently encountered systemic side effects of steroids. Each answer was rated as mild, moderate, or severe. Descriptive statistics were used to analyze and present the findings. Results The study included 49 patients (42 female and 7 male) with a mean age of 59.1 years (range 21–83 years). Post-SILSI treatment, 27 (55%) reported experiencing side effects while 22 (45%) patients reported no side effects. The most frequent side effect reported in women of reproductive age (n: 8) was menstrual irregularities (3/8, 37%). Other frequently reported side effects were feeling joyful and sleeping difficulties, each reported by 30% of the patients. All side effects resolved after the completion of SILSI. Conclusions SILSI can be administered with minimal tolerable side effects. Clinicians should make their patients aware of the most frequent side effects. Special attention should be given to women of reproductive age to inform them of the possibility of menstrual irregularities during SILSI. Keywords Subglottic stenosis · Intralesional steroid injection · Local steroid treatment · Steroid side effects
Introduction
* Ramon A. Franco Jr [email protected] 1
Istanbul Training and Research Hospital, Otolaryngology Head and Neck Surgery Clinic, Istanbul, Turkey
2
Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, USA
3
Department of Otolaryngology, Harvard Medica School, Boston, MA, USA
4
Department of Otorhinolaryngology, Faculty of Medicine, Srinakharinwirot University, Bangkok, Thailand
5
Department of Otolaryngology, Panyananthapikkhu Chonprathan Medical Center Srinakharinwirot University, Bangkok, Thailand
6
Division of Laryngology, Department of Otolaryngology, Voice and Speech Laboratory, Mass Eye and Ear, Harvard Medical School, 243 Charles Street, Boston, MA 02114, USA
Idiopathic subglottic stenosis (iSGS) is a disease characterized by inflammation and fibrosis of the subglottic region, resulting in progressive narrowing of the upper airway. The primary treatments for iSGS include open resection, endoscopic resection, and endoscopic dilation, as well as the use of pharmacological agents that address the inflammatory cascade, such as steroids and mitomycin C, each of which are associated with risks and recurrence of stenosis [1–3]. The existence of the
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