Clinical characteristics and treatment of subglottic stenosis in patients with Wegener’s granulomatosis

Abstract

Subglottic stenosis is a complication of Wegener’s granulomatosis caused by tracheal tissue damage and scarring. It may occur as a presenting feature of the disease leading to diagnosis, or instead as a late-stage manifestation. Frequently, it occurs or progresses independently of other features of active disease, and sometimes appears while the general disease is in remission under therapy. The diagnosis of isolated subglottic stenosis may be difficult histologically. Thus, a combination of clinical, histopathological and immunological tests is needed to establish the diagnosis. The management of subglottic stenosis is challenging. A subset of patients may not be responsive to immunosuppressant medication and fixed lesions may require surgical repair. An individualized approach that may include medical and interventional therapies is recommended.