Anesthesia
Anesthesia
If the affected body surface area (BSA) is not larger than approximately 0.5%, deroofing is exceptionally suitable as an “office procedure” with use of local anesthesia29 Local anesthesia is usually performed in two steps.25 First, an anesthetic containing lidocaine with epinephrine is injected to infiltrate the surrounding area. As previously described, adding sodium bicarbonate may reduce the burning sensation during injection.21 Additionally, the sinus tract can be injected with the same local anesthetic. Injecting the sinus with methylene blue can be used to assess the extent of the lesion(s). The procedure can be performed under procedural sedation and analgesia (PSA) or general anesthesia when preferred by the patient, or in cases of extensive inflammation or multiple lesions.