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Dilatation tracheoscopy for laryngeal and tracheal stenosis in patients with Wegener's granulomatosis.

Schokkenbroek AA, Franssen CF, Dikkers FG - Eur Arch Otorhinolaryngol (2007)

Bottom Line: Two patients did not experience a recurrence of SGS or TS.DT can offer a simple and repeatable solution to SGS and TS due to WG.One patient has a definitive tracheostoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, University Medical Center Groningen, University of Groningen, PO box 30001, 9700 RB Groningen, The Netherlands.

ABSTRACT
Wegener's granulomatosis (WG) frequently involves the subglottis and trachea and may compromise the upper airway. The objective of this study is to evaluate retrospectively the effect of treatment of subglottic stenosis (SGS) and tracheal stenosis (TS) by dilatation tracheoscopy (DT) in patients with WG. We performed a cohort study on all patients who underwent DT between February 2001 and September 2005 in our institution. From this cohort we identified a total of nine WG patients. In all patients, clinical, serological and histopathological data had been prospectively collected by a standardized protocol from the time point of diagnosis. In the nine patients that were identified with SGS or TS due to WG (eight women and one man), a total of 22 DT's were performed. Two patients needed a tracheostoma (one temporarily). The mean follow-up after the first DT was 25.4 +/- 14.1 months. Two patients did not experience a recurrence of SGS or TS. Six patients required a second DT without recurrence of local disease. The remaining patient underwent 8 DT's in a 4-year period. DT can offer a simple and repeatable solution to SGS and TS due to WG. Seven of the nine patients required more than one dilatation and some patients experience a functional restriction. One patient has a definitive tracheostoma.

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Groningen dilatation tracheoscope
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Fig1: Groningen dilatation tracheoscope

Mentions: DT was performed when patients complained of progressive dyspnoea in combination with decrease of peak flows. DT is an endoscopically performed intervention. An intubation laryngoscope, a Groningen optical dilatation tracheoscope (Karl Storz 1033R) (Fig. 1), telescope and suction tubes are required for this procedure. The tracheoscope has a length of 30 cm. The proximal end of the tracheoscope is designed in such a way that customary ventilation tubes and a 30 cm Hopkins® straight forward telescope (Karl Storz 27005AA) can be connected. The distal end of the instrument contains numerous lateral tiny openings, which enable air to come through in the centre of the stenosis. The dilatation tracheoscope is available with a diameter of 8 and 12 mm. The appropriate size of the instrument is determined by the size of the patient’s larynx and the healthy portion of the trachea.Fig. 1


Dilatation tracheoscopy for laryngeal and tracheal stenosis in patients with Wegener's granulomatosis.

Schokkenbroek AA, Franssen CF, Dikkers FG - Eur Arch Otorhinolaryngol (2007)

Groningen dilatation tracheoscope
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2279159&req=5

Fig1: Groningen dilatation tracheoscope
Mentions: DT was performed when patients complained of progressive dyspnoea in combination with decrease of peak flows. DT is an endoscopically performed intervention. An intubation laryngoscope, a Groningen optical dilatation tracheoscope (Karl Storz 1033R) (Fig. 1), telescope and suction tubes are required for this procedure. The tracheoscope has a length of 30 cm. The proximal end of the tracheoscope is designed in such a way that customary ventilation tubes and a 30 cm Hopkins® straight forward telescope (Karl Storz 27005AA) can be connected. The distal end of the instrument contains numerous lateral tiny openings, which enable air to come through in the centre of the stenosis. The dilatation tracheoscope is available with a diameter of 8 and 12 mm. The appropriate size of the instrument is determined by the size of the patient’s larynx and the healthy portion of the trachea.Fig. 1

Bottom Line: Two patients did not experience a recurrence of SGS or TS.DT can offer a simple and repeatable solution to SGS and TS due to WG.One patient has a definitive tracheostoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, University Medical Center Groningen, University of Groningen, PO box 30001, 9700 RB Groningen, The Netherlands.

ABSTRACT
Wegener's granulomatosis (WG) frequently involves the subglottis and trachea and may compromise the upper airway. The objective of this study is to evaluate retrospectively the effect of treatment of subglottic stenosis (SGS) and tracheal stenosis (TS) by dilatation tracheoscopy (DT) in patients with WG. We performed a cohort study on all patients who underwent DT between February 2001 and September 2005 in our institution. From this cohort we identified a total of nine WG patients. In all patients, clinical, serological and histopathological data had been prospectively collected by a standardized protocol from the time point of diagnosis. In the nine patients that were identified with SGS or TS due to WG (eight women and one man), a total of 22 DT's were performed. Two patients needed a tracheostoma (one temporarily). The mean follow-up after the first DT was 25.4 +/- 14.1 months. Two patients did not experience a recurrence of SGS or TS. Six patients required a second DT without recurrence of local disease. The remaining patient underwent 8 DT's in a 4-year period. DT can offer a simple and repeatable solution to SGS and TS due to WG. Seven of the nine patients required more than one dilatation and some patients experience a functional restriction. One patient has a definitive tracheostoma.

Show MeSH
Related in: MedlinePlus