What are in office/awake steroid injections?
More and more frequently, SGS patients are choosing to have a steroid injection in the doctor’s office. Here is more information about that technique.
Why would I choose to have a steroid injection?
Inflammation is a key part of SGS and often causes major issues with our breathing, even when the actual scarring is not too bad. Taking regular oral steroids can help but have many negative side effects. A set of injections directly at the site of the stenosis can have an immediate effect and can keep you breathing well for much longer – keeping the need for more major surgery at bay.
How often would I need an injection?
You are generally seen every four to six weeks for a course of 4-6 injections.
How long does the procedure take?
Including the local anaesthetic applied to your vocal cords and trachea, and the procedure itself, you should expect to be in the office for between 30 and 60 minutes.
Am I sedated or put under a general anaesthetic?
There is no general anaesthetic involved nor sedation (unless you specifically *Image source – Harvard Otolaryngology 10/2014 request it). The area is first numbed with an injection of lidocaine, a local anaesthetic. This will cause you to cough, spreading the anaesthetic through the trachea and voice box.
After it is numbed, what will the doctor do?
The doctor will use a bronchoscope to inspect the area, then inject the steroid into the scar.
Does the doctor inject from inside or outside of my neck?
This depends on your airway and the ease of inserting the scope with needle, also the thickness of your scar and the ease of penetrating it with the needle.
Will it affect my voice?
Some have a short-term huskiness while the vocal cords are numbed. This is temporary and usually eases within an hour of the procedure.
What difference would this make to my dilations?
Clinical data has shown that some patients can cope for long periods between dilations, often with higher peak flow numbers than they get with a dilation.
What are the risks of steroid injections?
Recent research (2022) finds 65% of patients receiving injections encounter temporary side effects with 23% experiencing 3 or more. These included flushing (38%), insomnia (23%), injection site pain (22%), temporarily increased stridor (20%), coughing up small amounts of blood (16%), heart palpitations (15%), fatigue (10%) and blurry vision (1.9%). Side effects requiring additional medical care and/or treatment are rare.