title: Airway reconstruction in Wegener's granulomatosis-associated laryngotracheal stenosis.
abstract: OBJECTIVE
  Open airway reconstruction is considered definitive treatment of laryngotracheal stenosis (LTS). Although most cases of LTS are not autoimmune, there are few data reported in patients with Wegener's granulomatosis. In this study, we aimed to assess outcomes of airway reconstruction in LTS patients with Wegener's compared to nonautoimmune patients.
  
  
  METHODS
  Retrospective chart review of LTS cases managed with open airway reconstruction at an academic medical center.
  
  
  METHODS
  Patients who underwent open airway reconstruction for LTS due to Wegener's or nonautoimmune causes were identified from 1995 to 2010. Clinical, demographic, and procedural data were recorded. Fisher exact test, Mann-Whitney U test, and McNemar's test were used to test for significance.
  
  
  RESULTS
  A total of 53 patients were identified; eight Wegener's, 45 nonautoimmune, with median follow-up time of 8.3 and 1.8 years, respectively. Before reconstruction, there was no statistical difference between Wegener's and nonautoimmune patients with previous dilations (88% vs. 68%, P = .41) and tracheostomy dependence (50% vs. 42%, P = .72). Following reconstruction, 75% Wegener's and 36% nonautoimmune patients required further dilations (P = .05), with a decannulation rate of 75% and 58% (P = 1.0), respectively.
  
  
  CONCLUSIONS
  Wegener's patients have an increased need for dilations after open airway reconstruction for LTS. However, these patients can be decannulated after surgery at a rate similar to patients with nonautoimmune LTS.
authors: School of Medicine, Oregon Health and Science University, Portland, Oregon 97239, USA.
authors: Jacob L
authors: JL
authors: Wester
authors: Daniel R
authors: DR
authors: Clayburgh
authors: William J
authors: WJ
authors: Stott
authors: Joshua S
authors: JS
authors: Schindler
authors: Peter E
authors: PE
authors: Andersen
authors: Neil D
authors: ND
authors: Gross
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology / Q000601:surgery*; D001999:Bronchoscopy / Q000379:methods; D016022:Case-Control Studies; D004106:Dilatation / Q000379:methods*; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D014135:Tracheal Stenosis / Q000209:etiology* / Q000601:surgery*; D055815:Young Adult