Wegener’s Granulomatosis
A rare inflammatory disease of small arteries and veins (vasculitis) that classically involves vessels supplying the tissues of the lungs, nasal passages (sinuses), and kidneys.
At our practice, we see a large population of individuals with what we believe to be a forme fruste (incomplete expression) of Wegener’s granulomatosis* causing subglottic and tracheal stenosis.
*Newer terminology is granulomatosis with polyangiitis (GPA)
Subglottic Stenosis, Due to Wegener’s Granulomatosis
Subglottic stenosis, due to Wegener’s (1 of 2)
Subglottic stenosis, due to Wegener’s (1 of 2)
Subglottic stenosis, due to Wegener’s (2 of 2)
Subglottic stenosis, due to Wegener’s (2 of 2)
Airway Stenosis Caused By Wegener’s Granulomatosis, Before and After Dilations
Airway stenosis (1 of 5)
Airway stenosis (1 of 5)
Airway stenosis, after dilation (2 of 5)
Airway stenosis, after dilation (2 of 5)
Airway stenosis, after dilation (3 of 5)
Airway stenosis, after dilation (3 of 5)
Airway stenosis, before another dilation (4 of 5)
Airway stenosis, before another dilation (4 of 5)
Airway stenosis, after another dilation (5 of 5)
Airway stenosis, after another dilation (5 of 5)
Vascular Manifestations of Wegener’s-related Septum Changes, and Subglottic Stenosis Indistinguishable from Forme Fruste Wegener’s
View inside left nostril (1 of 4)
View inside left nostril (1 of 4)
Narrow band light (2 of 4)
Narrow band light (2 of 4)
Distant view (3 of 4)
Distant view (3 of 4)
Closer view (4 of 4)
Closer view (4 of 4)

Wegener’s Granulomatosis*: Forme Fruste (incomplete expression)
Wegener’s granulomatosis is a rare autoimmune disorder in which blood vessels become inflamed. The inflammation causes swelling and scarring. Three typical organs attacked are sinus/nasal cavities, lungs, and kidneys.
In the forme fruste variant, it is mostly an inflammatory stenosis (narrowing) of the area below the vocal folds, and also the trachea. A person becomes short of breath and begins to make harsh breathing sounds due to the narrowed passageway.
This is an example of one means of management: dilation of the narrowed area during a very brief general anesthetic in an outpatient operating room.