Therapeutic challenges in Management of Subglottic Stenosis in Wegener's Granulomatosis

Abstract

ABSTRACT Aims and objectives To report our experience on the treatment of subglottic stenosis (SS) in patients with Wegener's granulomatosis (WG). Materials and methods We endoscopically treated five patients with SS due to WG. Out of 5, two patients were treated with endoscopic balloon dilatation, two patients underwent CO2 laser resection and dilatation and 1 patient underwent a cold steel resection and dilatation. Outcomes were assessed based on improvement in preoperative symptoms, complications, and need for additional procedures. Results Balloon dilatation was done in two patients. They are asymptomatic at follow-up and the one with tracheostomy is in the process of decannulation. The other two patients were treated with CO2 laser. Favorable outcome was obtained in one of the patient who is in the process of decannulation, the other developed recurrent stenosis at 3 years and is on tracheostomy. Cold steel resection was used to treat one patient. After undergoing multiple interventions, she developed severe stenosis and underwent an open procedure and is currently on tracheostomy. Conclusion Both use of balloon and laser resection are safe and successful method to manage soft, subglottic stenosis due to WG and avoids the need of open procedure. In our series balloon dilatation gave better outcomes as compared to Laser resection and dilatation. Regular follow-up is necessary to rule out recurrence. How to cite this article Nerurkar NK, Deshmukh S. Therapeutic challenges in Management of Subglottic Stenosis in Wegener's Granulomatosis. Int J Phonosurg Laryngol 2014;4(2):76-79.