Intranasal Corticosteroid Injection: Indications, Technique, and Complications

Abstract

The intranasal injection of corticosteroids for symptomatic relief of nasal obstruction in selected cases has been described by several authors1–8 and widely used for over 25 years. Recently, circulated reports of blindness following such injections caused a number of otolaryngologists to discontinue using the procedure. All reported cases of visual complications following intranasal corticosteroid injection are reviewed, 9,12,13,17 together with the reported experiences of the author20 and others15–17 who have successfully used the technique in thousands of cases. Preliminary topical cocainization of nasal mucosa and slow submucosal injection of a micronized corticosteroid suspension to minimize the risk of vasospasm and embolization involving the ophthalmic circulation are stressed. Indications for the procedure, the most common side effects, and the proper technique of injection are described.