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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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Patient nr 9 during DT. The dilatation tracheoscope is introduced through the stenosis. Parts of the tissue protrude through the tiny distal openings of the tracheoscope
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Fig3: Patient nr 9 during DT. The dilatation tracheoscope is introduced through the stenosis. Parts of the tissue protrude through the tiny distal openings of the tracheoscope

Mentions: The intervention is carried out under general anaesthesia. Following the administration of the anaesthesia, with ventilation taking place via an anaesthesia mask, the dilatation tracheoscope is introduced under endoscopic control. The stenosis is then visible through the vocal cords (Fig. 2). The bevelled design of the tip, which can be advanced forward through the stenosis, ensures that the ventilation is maintained during the process. The conical construction of the tip enables the instrument to be advanced up to the wider section of the tracheoscope (Fig. 3), after which the tracheoscope remains in place for 5 to 10 min.Fig. 2


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

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

Patient nr 9 during DT. The dilatation tracheoscope is introduced through the stenosis. Parts of the tissue protrude through the tiny distal openings of the tracheoscope
© Copyright Policy
Related In: Results  -  Collection

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

Fig3: Patient nr 9 during DT. The dilatation tracheoscope is introduced through the stenosis. Parts of the tissue protrude through the tiny distal openings of the tracheoscope
Mentions: The intervention is carried out under general anaesthesia. Following the administration of the anaesthesia, with ventilation taking place via an anaesthesia mask, the dilatation tracheoscope is introduced under endoscopic control. The stenosis is then visible through the vocal cords (Fig. 2). The bevelled design of the tip, which can be advanced forward through the stenosis, ensures that the ventilation is maintained during the process. The conical construction of the tip enables the instrument to be advanced up to the wider section of the tracheoscope (Fig. 3), after which the tracheoscope remains in place for 5 to 10 min.Fig. 2

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