title: Endoscopic laser surgery for subglottic stenosis in Wegener's granulomatosis.
abstract: OBJECTIVE
  Wegener's granulomatosis (WG) is a rare multisystem inflammatory disease, which infrequently involves the subglottic area and trachea. Treatment usually involves the use of immunosuppressive agents with corticosteroids. Some patients, however, continue to have symptoms of airway obstruction after clinical remission following the standard therapeutic regimen.
  
  
  OBJECTIVE
  To investigate laser treatment for subglottic stenosis in five patients suffering from WG.
  
  
  METHODS
  We endoscopically treated 5 patients with subglottic stenosis due to WG and airway obstruction by Nd:YAG and CO2 lasers. One of the patients had preoperative tracheostomy and after treatment was decannulated and could not breathe without dyspnea. Another patient required stenting of the subglottic area.
  
  
  RESULTS
  All five patients were able to breathe without dyspnea after the treatment. Three patients were treated with an Nd:YAG laser but needed repeated laser treatment every four to six months, whenever they complained of dyspnea. The other two patients were treated with a CO2 laser; one of these patients had preoperative tracheostomy and was treated twice by CO2 laser and decannulated, with no further difficulty in breathing. The follow-up period was 1-5 years.
  
  
  CONCLUSIONS
  Nd:YAG and CO2 lasers are recommended in the treatment of subglottic stenosis (SS) due to WG, particularly when the stenosis is in continuity or close proximity to the vocal cords.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel. asaf890@bezeqint.net
authors.forename: Jacob
authors.initials: J
authors.lastname: Shvero
authors.forename: David
authors.initials: D
authors.lastname: Shitrit
authors.forename: Rumelia
authors.initials: R
authors.lastname: Koren
authors.forename: Dekel
authors.initials: D
authors.lastname: Shalomi
authors.forename: Mordechai Reuven
authors.initials: MR
authors.lastname: Kramer
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D003251:Constriction, Pathologic / Q000601:surgery; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007828:Laryngoscopy; D007830:Larynx / Q000473:pathology / Q000601:surgery*; D053685:Laser Therapy; D008297:Male