The management of subglottic stenosis in patients with wegener's granulomatosis Academic Article uri icon

Overview

MeSH Major

  • Granulomatosis with Polyangiitis
  • Laryngostenosis
  • Tracheal Stenosis

abstract

  • Wegener's granulomatosis (WG) is a multisystem inflammatory disease characterized by vasculitis, granuloma formation, and necrosis. Among 158 patients treated at the National Institutes of Health during the past 24 years, 145 (92%) had an otolaryngologic manifestation of their disease and 25 (16%) had subglottic stenosis (SGS). SGS varied from asymptomatic to life-threatening. Sixteen (80%) of 20 patients with fixed SGS required surgical intervention, including manual dilations, carbon-dioxide laser resections, and laryngotracheoplasty (LTP). LTP was performed with and without microvascular reconstruction. Thirteen of the patients required tracheostomy and all 13 were ultimately decannulated. Five patients who repeatedly failed dilations and/or endoscopic laser surgery underwent LTP. Since 1987, two patients have undergone LTP with microvascular free flaps. Both patients were subsequently decannulated. The authors' experience demonstrates that management of SGS in WG is complex, requiring individualized frequent multimodality interventions to achieve satisfactory results. Microvascular laryngotracheal reconstruction should be considered in the surgical armamentarium for patients with persistent stenoses.

publication date

  • January 1992

Research

keywords

  • Academic Article

Identity

Language

  • eng

PubMed ID

  • 1453838

Additional Document Info

start page

  • 1341

end page

  • 5

volume

  • 102

number

  • 12