Endoscopic Laser Surgery for Subglottic Stenosis in Wegener’s Granulomatosis
1
조회
0
다운로드
0
인용
0
참고문헌
초록
Abstract
Purpose: 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. Materials and 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.
참고문헌 (14)
- O'Devaney K, "Wegener's granulomatosis of the head and neck", 107, pp.439~445 (1998)
- Dedo HH, "Endoscopic laser repair of posterior glottic subglottic and tracheal stenosis by division or micro-trapdoor flap", pp.445~50
- Walton EW, "Giant-cell granuloma of the respiratory tract", pp.265~70
- Arauz JC, "Wegener's granulomatosis appearing initially in the trachea", pp.593~6
- McDonald TJ, "Wegener's granulomatosis of the subglottis and the upper portion of the trachea", pp.588~92
- Alaani A, "Wegener's granulomatosis and subglottic stenosis: management of the airway", 118, pp.786~790 (2004)
- Nishiike S, "Management and follow-up of localized Wegener's granulomatosis: a review of five cases", 124, pp.1103~1108 (2004)
- Eliachar I, "New approaches to the management of subglottic stenosis in Wegener's granulomatosis", 69, pp.SII149~SII151 (2002)
- Herridge MS, "Subglottic stenosis complicating Wegener's granulomatosis: surgical repair as a viable treatment option", 111, pp.961~966 (1996)
- Hoffman GS, "The management of subglottic stenosis in patients with Wegener's granulomatosis", pp.1341~5
- Strong MS, "Endoscopic management of laryngeal stenosis", pp.797~805
- Gluth MB, "Subglottic stenosis associated with Wegener's granulomatosis", 113, pp.1304~1307 (2003)
- Utzig MJ, "Role of thoracic surgery and interventional bronchoscopy in Wegener's granulomatosis", 74, pp.1948~1952 (2002)
- Stegeman CA, "Trimethoprim-sulfamethoxazole (co-trimoxazole) for the prevention of relapses of Wegener's granulomatosis. Dutch Co-Trimoxazole Wegener Study Group", 335, pp.16~20 (1996)