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subglot-steno-slides-080521

subglot-steno-slides-080521 - Subglottic Stenosis in...

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Subglottic Stenosis in Subglottic Stenosis in Wegenger’s Granulomatosis Wegenger’s Granulomatosis Chad Simon, MD Susan McCammon, MD University of Texas Medical Branch Department of Otolaryngology Grand Rounds Presentation May 21, 2008
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Case Study Case Study A 26 year old female patient was referred to your clinic from pulmonology after pulmonary function tests indicated a fixed, extrathoracic, airway obstruction.
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Case Study Case Study The patient complained of dyspnea on exertion. She denied stridor or voice change. She had been treated for about 1 year by her family doctor for presumed asthma.
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Case Study Case Study Review of systems was positive for night sweats, achy joints, and nasal congestion. Her past medical history was positive for recurrent sinusitis and epistaxis. Family and social history were unremarkable. She used an albuterol inhaler as needed for shortness of breath. She had no drug allergies.
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Case Study Case Study Physical exam revealed nasal septal perforation on anterior rhinoscopy.
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Case Study Case Study Physical also revealed bilateral otitis media with effusion and mild conjunctivitis.
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Case Study Case Study Fiberoptic exam revealed a 60% (Cotton- Myer grade II) subglottic stenosis with the appearance of a mature scar.
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Outline Outline Overview Pathogenesis Epidemiology Pathophysiology Diagnosis Treatment
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Overview Overview In 1931, Heinz Klinger of the University of Berlin first reported two patients who died having prolonged sepsis with inflammation of blood vessels scattered throughout the body. Five years later, Friederic Wegener in Breslau described a distinct syndrome in three patients. These patients were found to have necrotizing granulomas involving the upper and lower respiratory tract. In 1954, seven more patients were described, resulting in the establishment of the definite criteria for the diagnosis of the disease described by Wegener.
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Overview Overview Wegener joined the Nazi Party in 1932. As a high ranking military doctor he spent some of WWII in a medical office near a Jewish ghetto in Lodz, Poland. There is speculation that he participated in experiments on concentration camp inmates. After his Nazi past was discovered in 2000, the chest physician group began a movement to rename Wegener's granulomatosis. Dr. Friederic Wegener died in July of 1990 at the age of 83.
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Overview Overview Wegener’s Granulomatosis is a necrotizing granulomatous vasculitis of autoimmune origin The disease has a predilection for the upper and lower respiratory tracts and the kidneys In the sinonasal tract, the vasculitis can cause sinusitis, nasal crusting, epistaxis, septal perforation and saddle-nose deformity.
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