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Subglottic stenosis associated with Wegener's granulomatosis
Michael B Gluth1, Patrick A Shinners, Jan L Kasperbauer
1Department of Otolarynology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA. gluth.Michael@mayo.edu
The Laryngoscope
|August 5, 2003
Summary
Wegener's granulomatosis can cause subglottic stenosis, often requiring airway intervention. Surgical reconstruction offers favorable outcomes for patients with this condition.
Area of Science:
- Otolaryngology
- Rheumatology
- Pulmonology
Background:
- Wegener's granulomatosis, a necrotizing vasculitis, can affect the subglottic airway.
- Subglottic stenosis is a potential complication, impacting airway patency.
Purpose of the Study:
- To evaluate the management and outcomes of subglottic stenosis in patients diagnosed with Wegener's granulomatosis.
Main Methods:
- Retrospective chart review of patients with Wegener's granulomatosis and subglottic stenosis.
- Analysis of airway management strategies, including tracheotomy, surgical procedures, and follow-up duration.
Main Results:
- Twenty-seven patients were identified with Wegener's granulomatosis and subglottic stenosis.
- 40.7% required tracheotomy, and 48.1% needed multiple surgical procedures.
- Open laryngotracheal reconstruction resulted in successful decannulation for all patients.
Conclusions:
- Airway management for subglottic stenosis in Wegener's granulomatosis involves tracheotomy during acute inflammation.
- Minimizing airway manipulation during active systemic disease is recommended.
- Both endoscopic and open surgical approaches, including laryngotracheal reconstruction or CO2 laser resection, yield favorable outcomes after disease control.