Wegener’s Granulomatosis

What is it?
Wegener’s granulomatosis, now termed granulomatosis with polyangiitis, is a chronic inflammatory disorder that primarily affects the kidneys and respiratory tract, including the lower airway (lungs and trachea) and upper airway (nasal cavity, pharynx, and larynx).  In the head and neck region, symptoms can include nasal crusting, sinusitis, nose bleeds, ear drainage, and breathing difficulty related to narrowing of the airway just below the vocal folds (in the subglottis and upper trachea).

How is it treated?
Wegener’s granulomatosis should be managed primarily by a specialist in the disorder, typically a rheumatologist, but head and neck symptoms are treated by otolaryngologists-head and neck surgeons.  Airway narrowing in the subglottis or upper trachea can often be managed by endoscopic, minimally-invasive airway expansion surgery with immediate symptomatic improvement.  Open surgery is typically avoided, as poor healing is often a concern with Wegner’s disease.