Airway reconstruction in Wegener's granulomatosis-associated laryngotracheal stenosis

Jacob L. Wester, Daniel Clayburgh, William J. Stott, Joshua Schindler, Peter Andersen, Neil D. Gross

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objectives/Hypothesis: 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. Study Design: 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.

Original languageEnglish (US)
Pages (from-to)2566-2571
Number of pages6
JournalLaryngoscope
Volume121
Issue number12
DOIs
StatePublished - Dec 2011

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Granulomatosis with Polyangiitis
Pathologic Constriction
Dilatation
Tracheostomy
Nonparametric Statistics
Retrospective Studies
Demography

Keywords

  • airway reconstruction
  • Airway stenosis
  • Wegener's granulomatosis

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Airway reconstruction in Wegener's granulomatosis-associated laryngotracheal stenosis. / Wester, Jacob L.; Clayburgh, Daniel; Stott, William J.; Schindler, Joshua; Andersen, Peter; Gross, Neil D.

In: Laryngoscope, Vol. 121, No. 12, 12.2011, p. 2566-2571.

Research output: Contribution to journalArticle

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abstract = "Objectives/Hypothesis: 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. Study Design: 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.",
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