Chest
Clinical Investigations: MiscellaneousUse of Metallic Stents in Relapsing Polychondritis
Section snippets
CASE REPORT
A 67-year-old woman known to haw relapsing polychondritis with tracheobronchial involvement was referred to our unit for elective tracheal stenting. She first presented 18 months prior to this hospital admission with a 2-year history of tiredness, weight loss, poor appetite, and generalized joint pain. Six months later, her nose had changed shape and she developed stridor when King down. At that time, she was noted to have episcleritis, audible stridor, and a saddle-shaped nose. There was also
DISCUSSION
Relapsing polychondritis was first described in 1923 by Jaksch-Wartenhorst4 who outlined the nasal and auricular deformities together with vertigo and hearing loss. Thirteen years later, Altherr5 and Von Meyerburg6 reported cases of chondromalacia involving cartilage of the ears, nose, ribs, joints, larynx, and tracheobronchial tree. Pearson et al7 suggested the term relapsing polychondritis because of the episodic nature of the disease. Diagnostic criteria were further elucidated by Mc Adam et
CONCLUSION
Tracheostomy was previously considered the most likely surgical procedure in relapsing polychondritis.26 However, this procedure alone without continuous positive airway pressure has no role in cases of airway collapse caused by extensive tracheobronchial involvement. Stenting of the respiratory tree may be an alternative form of treatment in these patients obviating the need for complex high-risk anesthetic and surgical procedures.
ACKNOWLEDGMENTS
We are grateful to Dr. Jane Bembridge, Dr. Selsby, and Dr. Fairbrass who were also involved in care of this patient. Our gratitude is also offered to Mr. Jibah Eng who gave us considerable help in the preparation of this article.
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