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Can we please reconsider intranasal injections?
  • William Moss
William Moss

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Introduction: Intranasal steroid injections were once routinely performed for refractory allergy patients worldwide. Due to concerns about visual complications, the procedure is very rarely performed today. Nonetheless, many studies evaluating the technique advocate for its use. Methods: A narrative review of the history of intranasal steroid injections was performed. Additionally, the analogous experiences of non-otolaryngology providers with steroid injection treatments were assessed. Results: Many non-otolaryngology providers have had similar, devastating thromboembolic complications from particulate steroid injections. In other fields, a switch to non-particulate steroid formulations (e.g. dexamethasone) appears to avoid the risk of thromboembolic events entirely without sacrificing effectiveness. Conclusion: The otolaryngologists’ aversion to intranasal injection treatments may not be evidence-based. Intranasal injection treatments with non-particulate steroids as well as other medications merit consideration.