title: Acute glutaraldehyde mucosal injury of the upper aerodigestive tract due to damage to the working channel of an endoscope.
abstract: OBJECTIVE
  Glutaraldehyde (Cidex) is a commonly used agent for cold sterilization of endoscopes despite its known irritative, allergic, and carcinogenic potential. This report details the clinical course of 2 patients who suffered acute glutaraldehyde exposure during office injection procedures.
  
  
  METHODS
  Clinical records of 2 outpatients undergoing office injection procedures were reviewed. One patient underwent bilateral injections of hydroxyapatite, and 1 underwent voice gel injection.
  
  
  RESULTS
  Both patients developed acute mucosal injury in the form of supraglottitis and laryngitis. Both patients required inpatient admission with airway monitoring (1 requiring admission to the intensive care unit) and were treated with steroids and antibiotics. The same channel endoscope was used for both procedures and was noted after careful examination to have retained glutaraldehyde inside the scope due to a perforation of the lining of the working channel.
  
  
  CONCLUSIONS
  Glutaraldehyde can cause acute mucosal injury to supraglottic and glottic structures, and diligent procedures must be maintained for flushing the channels and monitoring glutaraldehyde retention in the channels. Great care should be taken to avoid damage to the lining of working channels from instrumentation.
authors.affiliation: Division of Laryngology, Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
authors.forename: Priya D
authors.initials: PD
authors.lastname: Krishna
authors.forename: Melissa McCarty
authors.initials: MM
authors.lastname: Statham
authors.forename: Clark A
authors.initials: CA
authors.lastname: Rosen
mesh_terms: D000208:Acute Disease; D000369:Aged, 80 and over; D002057:Burns, Chemical / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D004202:Disinfectants / Q000009:adverse effects*; D005500:Follow-Up Studies; D005976:Glutaral / Q000009:adverse effects*; D006801:Humans; D007827:Laryngitis / Q000139:chemically induced* / Q000175:diagnosis; D020704:Laryngoscopes; D007828:Laryngoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D020545:Respiratory Mucosa / Q000187:drug effects / Q000293:injuries* / Q000473:pathology
chemical_list: D004202:Disinfectants; D005976:Glutaral