New treatment of subglottic stenosis due to Wegener's granulomatosis.
CONCLUSIONS
The presented new endoscopic surgical technique offers a safe and successful approach for treatment of subglottic stenosis due to Wegener's granulomatosis.


OBJECTIVE
Subglottic stenosis is a potentially limiting and complex condition among patients with Wegener's granulomatosis. It causes various symptoms and often requires interventional therapy. The purpose of this study was to evaluate a new endoscopic submucosal technique.


METHODS
Altogether 13 consecutive patients with subglottic stenosis due to Wegener's granulomatosis were treated with a new endoscopic technique. The procedure was carried out endoscopically, removing the stenotic part submucosally, sealing back the raised mucosal flap, and the bare areas were soaked with mitomycin-C. Follow-up telephone interviews were carried out and hospital records were reviewed.


RESULTS
Patients included 3 males and 10 females, with an average age of 37.5 years. A total of 37 procedures were performed, with an average of 2.8 procedures per patient. There was a statistically significant reduction in the all symptoms related to the stenoses (p < 0.05). Mean follow-up period was 3.5 years (range 1.5-6.5 years). Overall success rate was 85%. Only one patient relapsed following adequate medical and surgical treatment. No perioperative mortality was recorded.
Department of Clinical Science, Intervention and Technology, Division of Otorhinolaryngology, Karolinska Institutet, Stockholm, Sweden.
Julia
J
Arebro
Gert
G
Henriksson
Paolo
P
Macchiarini
Jan-Erik
JE
Juto
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D004210:Dissection / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D014890:Granulomatosis with Polyangiitis / Q000150:complications / Q000601:surgery*; D006611:High-Frequency Jet Ventilation; D006801:Humans; D007820:Laryngeal Mucosa / Q000601:surgery; D007828:Laryngoscopy; D007829:Laryngostenosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D019384:Nucleic Acid Synthesis Inhibitors / Q000008:administration & dosage; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D011788:Quality of Life; D012086:Reoperation; D013524:Surgical Flaps; D055815:Young Adult
D019384:Nucleic Acid Synthesis Inhibitors; D016685:Mitomycin