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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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Peak flow measurements after dilatation of patient number 9. The arrows indicate the DT procedures
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Fig6: Peak flow measurements after dilatation of patient number 9. The arrows indicate the DT procedures

Mentions: The effect of DT on peakflows was evaluated in five patients. In these patients the mean (±SD) peakflow increased from 164 ± 45.7 l/min before DT to 226 ± 69.6 l/min after dilatation. An example of the effect of DT on the peakflow is shown in Fig. 6. Two months after this patient had been diagnosed with WG she developed complaints of dyspnoea. Tracheoscopy revealed a SGS with signs of active vasculitis. After treatment with high-dose corticosteroids she had a regression of the WG activity. Fourteen and 28 months after first diagnosis of SGS a dilatation tracheoscopy was performed successfully.Fig. 6


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

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

Peak flow measurements after dilatation of patient number 9. The arrows indicate the DT procedures
© Copyright Policy
Related In: Results  -  Collection

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

Fig6: Peak flow measurements after dilatation of patient number 9. The arrows indicate the DT procedures
Mentions: The effect of DT on peakflows was evaluated in five patients. In these patients the mean (±SD) peakflow increased from 164 ± 45.7 l/min before DT to 226 ± 69.6 l/min after dilatation. An example of the effect of DT on the peakflow is shown in Fig. 6. Two months after this patient had been diagnosed with WG she developed complaints of dyspnoea. Tracheoscopy revealed a SGS with signs of active vasculitis. After treatment with high-dose corticosteroids she had a regression of the WG activity. Fourteen and 28 months after first diagnosis of SGS a dilatation tracheoscopy was performed successfully.Fig. 6

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