Surgical repair with palatal mucosal graft in subglottic stenosis caused by Wegener’s granulomatosis

Laryngeal and subglottic stenosis are present in about 20% of patients with granulomatosis with polyangiitis. This atypical form of the disease can be severe and life-threatening. In what concerns to treatment, subglottic lesions are less responsive to conventional systemic therapy and interventional and surgical procedures should be considered. The authors present a case of a 30-year-old woman with diagnosis of Wegener’s granulomatosis who presented to our department with dyspnea and stridor due to a severe subglottic stenosis, requiring an emergent tracheostomy. The obstructive defect was electively and effectively repaired through a transoral laser microsurgery using local application prednisolone and mitomycin C followed by balloon dilation.

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Endoscopic Management of Severe Subglottic Stenosis in Wegener's Granulomatosis

Clinical Rheumatology ◽

10.1007/s100670070053 ◽

2000 ◽

Vol 19 (4) ◽

pp. 315-317 ◽

Cited By ~ 17

Author(s):

I. Stappaerts ◽

C. Van Laer ◽

K. Deschepper ◽

P. Van de Heyning ◽

P. Vermeire

Keyword(s):

Wegener’S Granulomatosis ◽

Wegener's Granulomatosis ◽

Subglottic Stenosis ◽

Endoscopic Management

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Progressive Subglottic Stenosis In A Child-could It Be Seronegative Isolated Wegener's Granulomatosis?

10.1164/ajrccm-conference.2010.181.1_meetingabstracts.a6215 ◽

2010 ◽

Author(s):

Pravin K. Sah ◽

Syboney Zapata ◽

Dawn Simon

Keyword(s):

Wegener’S Granulomatosis ◽

Wegener's Granulomatosis ◽

Subglottic Stenosis

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Wegener's Granulomatosis Presenting as Subglottic Stenosis

JCR Journal of Clinical Rheumatology ◽

10.1097/00124743-200104000-00008 ◽

2001 ◽

Vol 7 (2) ◽

pp. 91-96 ◽

Cited By ~ 3

Author(s):

Mayra Guerrero ◽

Eric Gall ◽

Ermias Tilahun ◽

Jack Garon

Keyword(s):

Wegener’S Granulomatosis ◽

Wegener's Granulomatosis ◽

Subglottic Stenosis

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Endoscopic Laser Surgery for Subglottic Stenosis in Wegener's Granulomatosis

Yonsei Medical Journal ◽

10.3349/ymj.2007.48.5.748 ◽

2007 ◽

Vol 48 (5) ◽

pp. 748 ◽

Cited By ~ 12

Author(s):

Jacob Shvero ◽

David Shitrit ◽

Rumelia Koren ◽

Dekel Shalomi ◽

Mordechai Reuven Kramer

Keyword(s):

Laser Surgery ◽

Wegener’S Granulomatosis ◽

Wegener's Granulomatosis ◽

Subglottic Stenosis ◽

Endoscopic Laser ◽

Endoscopic Laser Surgery

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Wegener's granulomatosis, subglottic stenosis and antineutrophil cytoplasm antibodies.

The Journal of Laryngology & Otology ◽

10.1017/s0022215100111314 ◽

1989 ◽

Vol 103 (12) ◽

pp. 1187-1191 ◽

Cited By ~ 20

Author(s):

T. J. Hoare ◽

D. Jayne ◽

P. Rhys Evans ◽

C. B. Croft ◽

D. J. Howard

Keyword(s):

Wegener’S Granulomatosis ◽

Wegener's Granulomatosis ◽

Subglottic Stenosis ◽

The Past ◽

The Future

AbstractWegener's granulomatosis is difficult to diagnose, especially when the presentation is unusual, restricted to an isolated region. We report four cases of recurrent subglottic stenosis posing difficulty in diagnosis. In each case the finding of anti-neutrophil cytoplasm antibodies (ANCA) strongly suggested an underlying vasculitic pathology, Wegener's granulomatosis. We discuss reasons for the difficulty in diagnosis in the past, the possible role of the ANCA assay in such patients, and suggest it should be more widely used in the future.

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Aspiration and development of subglottic stenosis in patients with Wegener’s granulomatosis

The Journal of Laryngology & Otology ◽

10.1017/s0022215109991952 ◽

2009 ◽

Vol 124 (4) ◽

pp. 393-396 ◽

Cited By ~ 4

Author(s):

A C Church ◽

K Goldsmith ◽

P Sivasothy

Keyword(s):

Gastroesophageal Reflux ◽

Reflux Disease ◽

Bile Salts ◽

Wegener’S Granulomatosis ◽

Ph Monitoring ◽

Wegener's Granulomatosis ◽

Middle Lobe ◽

Subglottic Stenosis ◽

Aetiological Factor ◽

Significant Difference

AbstractObjective:In patients with Wegener’s granulomatosis, subglottic stenosis can develop due to active disease; however, some patients develop subglottic stenosis with no clear evidence of airway inflammation. In some cases of idiopathic subglottic stenosis, an association with gastroesophageal reflux disease has been found. Our study assessed the potential role of gastroesophageal reflux as an aetiological factor in the development of subglottic stenosis in patients with Wegener’s granulomatosis.Design:We assessed evidence of active reflux disease, using 24-hour pH monitoring and assessment of bile salts in bronchoalveolar lavage fluid.Subjects:Ten Wegener’s granulomatosis patients with subglottic stenosis underwent 24-hour pH monitoring and bronchoscopy and lavage of the right middle lobe. A similar number of control patients were included.Results:There was no statistically significant difference in the occurrence of bronchoalveolar bile salts in patients with subglottic stenosis (n = 2) versus control patients (zero) (p = 0.457). There was good correlation between the detection of reflux by 24-hour pH monitoring and the detection of bronchoalveolar bile salts (κ = 0.769).Conclusion:In this small study of patients with Wegener’s granulomatosis, there was no evidence of an association between the development of subglottic stenosis and gastroesophageal reflux.

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