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Percutaneous Ultrasound-Guided Medication Injection: A Potential Technique for Subglottic Stenosis.

Mingming Deng1, Run Tong1, Jieru Lin2

  • 1National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.

Respiration; International Review of Thoracic Diseases
|July 2, 2024
PubMed
Summary

Submucosal corticosteroid injections, guided by Point-of-Care Ultrasound (POCUS), offer a safe and cost-effective adjunctive therapy for complex subglottic stenosis. This method helps manage granulation tissue hyperplasia and reduces the risk of airway restenosis.

Keywords:
Percutaneous ultrasound-guided medication injectionSubglottic stenosisSubmucosal triamcinolone injection

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Area of Science:

  • Otolaryngology
  • Pulmonology
  • Interventional Pulmonology

Background:

  • Subglottic stenosis, characterized by granulation tissue hyperplasia, presents a significant clinical challenge requiring repeated interventions and stent maintenance.
  • Corticosteroids possess antifibrotic and anti-inflammatory properties beneficial in preventing severe subglottic stenosis.
  • Submucosal glucocorticoid injection is an established adjuvant therapy that increases the interval between endoscopic procedures and lowers restenosis risks.

Observation:

  • A rare case of complex subglottic stenosis in a male patient is presented.
  • The patient underwent a multimodal treatment approach including balloon dilatation, cryotherapy, stent placement, and submucosal triamcinolone injection.
  • Percutaneous ultrasound guidance was utilized for safe and efficient drug delivery into the submucosal layer.

Findings:

  • Point-of-Care Ultrasound (POCUS)-guided submucosal injection of triamcinolone was successfully performed.
  • The adjuvant therapy effectively controlled subglottic stenosis.
  • The treatment approach was found to be cost-effective.

Implications:

  • POCUS-guided medication injection represents a valuable adjuvant therapeutic modality for managing subglottic stenosis.
  • This technique may improve patient outcomes by reducing the need for frequent endoscopic interventions.
  • The findings support the integration of POCUS-guided injections into the treatment algorithm for subglottic stenosis.