New treatment of subglottic stenosis due to Wegener's granulomatosis

• Published in: Acta oto-laryngologica 2012-09, Vol.132 (9), p.995-1001
• Main Authors: Arebro, Julia, Henriksson, Gert, Macchiarini, Paolo, Juto, Jan-Erik
• Format: Article
• Language: English
• Subjects: Administration, Topical; Adolescent; Adult; Aged; Biological and medical sciences; Combined Modality Therapy; Dissection - methods; Endoscopic technique; Female; Follow-Up Studies; Granulomatosis with Polyangiitis - complications; Granulomatosis with Polyangiitis - surgery; High-Frequency Jet Ventilation; Humans; Laryngeal Mucosa - surgery; Laryngoscopy; Laryngostenosis - etiology; Laryngostenosis - surgery; Male; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Mitomycin - administration & dosage; Nucleic Acid Synthesis Inhibitors - administration & dosage; Otorhinolaryngology. Stomatology; Postoperative Complications - etiology; Postoperative Complications - therapy; Quality of Life; Reoperation; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; submucosal technique; Surgical Flaps; Young Adult
• ISSN: 0001-6489; 1651-2251; 1651-2251
• DOI: 10.3109/00016489.2012.674213

Abstract Conclusions: The presented new endoscopic surgical technique offers a safe and successful approach for treatment of subglottic stenosis due to Wegener's granulomatosis. Objective: Subglottic stenosis is a potentially limiting and complex condition among patients with Wegener's granulomatosis. It causes various symptoms and often requires interventional therapy. The purpose of this study was to evaluate a new endoscopic submucosal technique. Methods: Altogether 13 consecutive patients with subglottic stenosis due to Wegener's granulomatosis were treated with a new endoscopic technique. The procedure was carried out endoscopically, removing the stenotic part submucosally, sealing back the raised mucosal flap, and the bare areas were soaked with mitomycin-C. Follow-up telephone interviews were carried out and hospital records were reviewed. Results: Patients included 3 males and 10 females, with an average age of 37.5 years. A total of 37 procedures were performed, with an average of 2.8 procedures per patient. There was a statistically significant reduction in the all symptoms related to the stenoses (p < 0.05). Mean follow-up period was 3.5 years (range 1.5-6.5 years). Overall success rate was 85%. Only one patient relapsed following adequate medical and surgical treatment. No perioperative mortality was recorded.