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Endoscopic Laser Surgery for Subglottic Stenosis in Wegener's Granulomatosis Jacob Shvero, David Shitrit ,  Rumelia Koren , Dekel Shalom, Mordehai Reuven Kramer  Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Introduction ,[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object]
Material and Methods  Patients   ,[object Object],[object Object],[object Object]
Material and Methods   Patients ,[object Object],[object Object],[object Object],[object Object]
Table 1. Clinical data of five patients with subglottic stenosis *Distance of the stenosis from the vocal cord (cm) 0.5 6, anterior 1.5 No No No 25/F 5 0.5 6, anterior 1 No No No 83/F 4 1 4, circular 3 No No Saddle nose 25/F 3 1.5 5, circular 2 No No Saddle nose Septal perforation 20/M 2 1 Total  1 No Yes Saddle nose Chronic sinusitis 29/F 1 Distance/ cm* Diameter/ mm Thickness/ cm Postop Preop Stenosis Tracheostomy Nose/ Sinus Age/Sex No
Material and Methods   Patients ,[object Object],[object Object]
Fig. 1  Diagram of treatment of subglottic stenosis
Material and Methods   Surgical procedure   ,[object Object],[object Object],[object Object]
Material and Methods   Surgical procedure ,[object Object],[object Object]
Material and Methods   Surgical procedure ,[object Object],[object Object],[object Object],[object Object],[object Object]
Fig. 2.Tracheoscopic image of preoperative subglottic stenosis
Results   ,[object Object],[object Object],[object Object]
Results ,[object Object],[object Object],[object Object]
Table 2. Laser treatment and follow-up * stent 6 Favorable 4* - Yes 5 24 Favorable 5 Yes - 4 6 Favorable 18 Yes - 3 60 Favorable 10 Yes - 2 12 Decanulated 2 - Yes + dilatation 1 Followup/ months Outcome No. of interventions Nd:YAG  laser CO 2  laser No.
Results ,[object Object],[object Object],[object Object]
Results ,[object Object],[object Object],[object Object],[object Object]
Fig. 3. Postoperative pulmonary function testing
Fig. 4.Tracheoscopic image of postoperative subglottic stenosis
Results Histological examination   ,[object Object],[object Object],[object Object]
Fig. 5  Microscopical examination of subglottic Wegener’s granulomatosis demonstrates granuloma with central necrosis and a multinucleate giant cell, small artery with markedly thickened wall and infiltrated with white cells.
Discussion ,[object Object],[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object],[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object],[object Object]
Discussion ,[object Object],[object Object]
Discussion ,[object Object],[object Object]
Discussion ,[object Object],[object Object]
Conclusion   ,[object Object],[object Object],[object Object],[object Object]
Conclusion ,[object Object],[object Object]

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5749 Endoscopic Laser Surgery For Subglottic Stenosis In Wegeners Granulomatosis

  • 1. Endoscopic Laser Surgery for Subglottic Stenosis in Wegener's Granulomatosis Jacob Shvero, David Shitrit , Rumelia Koren , Dekel Shalom, Mordehai Reuven Kramer Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7. Table 1. Clinical data of five patients with subglottic stenosis *Distance of the stenosis from the vocal cord (cm) 0.5 6, anterior 1.5 No No No 25/F 5 0.5 6, anterior 1 No No No 83/F 4 1 4, circular 3 No No Saddle nose 25/F 3 1.5 5, circular 2 No No Saddle nose Septal perforation 20/M 2 1 Total 1 No Yes Saddle nose Chronic sinusitis 29/F 1 Distance/ cm* Diameter/ mm Thickness/ cm Postop Preop Stenosis Tracheostomy Nose/ Sinus Age/Sex No
  • 8.
  • 9. Fig. 1 Diagram of treatment of subglottic stenosis
  • 10.
  • 11.
  • 12.
  • 13. Fig. 2.Tracheoscopic image of preoperative subglottic stenosis
  • 14.
  • 15.
  • 16. Table 2. Laser treatment and follow-up * stent 6 Favorable 4* - Yes 5 24 Favorable 5 Yes - 4 6 Favorable 18 Yes - 3 60 Favorable 10 Yes - 2 12 Decanulated 2 - Yes + dilatation 1 Followup/ months Outcome No. of interventions Nd:YAG laser CO 2 laser No.
  • 17.
  • 18.
  • 19. Fig. 3. Postoperative pulmonary function testing
  • 20. Fig. 4.Tracheoscopic image of postoperative subglottic stenosis
  • 21.
  • 22. Fig. 5 Microscopical examination of subglottic Wegener’s granulomatosis demonstrates granuloma with central necrosis and a multinucleate giant cell, small artery with markedly thickened wall and infiltrated with white cells.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.