Management of radiation-related supraglottic stenosis with serial in-office steroid injections

Authors

  • Christine M. Kim Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA http://orcid.org/0000-0002-1087-8066
  • Pratik B. Patel Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA
  • Aaron J. Feinstein Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA
  • Dinesh K. Chhetri Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20185311

Keywords:

Supraglottic stenosis, Radiation, Head and neck cancer, Steroid injection, Dysphagia

Abstract

Management of supraglottic stenosis in patients with history of head and neck radiation presents a clinical challenge for otolaryngologists. The cornerstone of treatment has historically been surgical intervention, both endoscopic and open. However, recently described techniques related to outpatient management of subglottic and tracheal stenosis with routine in-office steroid injections may provide a translatable model for supraglottic stenosis management. We describe a clinical protocol for in-office steroid injections to the laryngopharynx for patients with supraglottic stenosis secondary to radiation fibrosis. Two patient cases are reported, including endoscopic examinations over a follow-up period of 12 to 16 months. Both patients experienced significant improvement in their supraglottic airways. In-office steroid injections may be beneficial to prevent or slow stenosis recurrence in patients treated with radiation for head and neck cancer. With continued refinement of this technique, a paradigm shift may occur in the management of supraglottic stenosis.

Author Biography

Christine M. Kim, Department of Head and Neck Surgery, David Geffen School of Medicine at University of California, Los Angeles (UCLA), Los Angeles, California, USA

Resident, Head and Neck Surgery

References

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Franco RA Jr, Husain I, Reder L, Paddle P. Awake serial intralesional steroid injections without surgery as a novel targeted treatment for idiopathic subglottic stenosis. Laryngoscope. 2017;128(3):610-7.

Bertelsen C, Shoffel-Havakuk H, O'Dell K, Johns MM 3rd, Reder LS. Serial In-Office Intralesional Steroid Injections in Airway Stenosis. JAMA Otolaryngol Head Neck Surg. 2018;144(3):203-10.

Hoffman MR, Mai JP, Dailey SH. Idiopathic Supraglottic Stenosis Refractory to Multiple Interventions Improved With Serial Office-based Steroid Injections. J Voice. 2017;32(6):767-9.

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Published

2018-12-25