A case of relapsing polychondritis resulting in laryngectomy.

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A case, 46-year-old female, of relapsing polychondritis was experienced. She complained of hoarsness and dyspnea. Under indirect laryngoscope, both falsevocal cords were found swelling and granulomatic stenosis was observed in subglottic space. But mobility of vocal cord was normal. The X-ray examination showed subglottical stenosis and narrow trachea. The collaps of nasal chondro-septum was observed.As a first aid, tracheostomy was performed for subglottical stenosis. However, dyspnea increased, resulting in necessity of respiratory control with intubation. Pathology of the bronchial cartilage was strongly suspected relapsing polychondritis.Regardless of tracheostomy and treatment with steroid and Dapsone®, dyspnea and narrow trachea increased more and more. Total laryngectomy was performed for the purpose of the improvement of dyspnea and the prevention of aspiration pneumonia. Two-three weeks after laryngectomy, narrow trachea was improved and dyspnea disappeared.We considered that by a dicreasing of compliance in upper respiratory system, the pathological improvement was obtained in main bronchus. A better ventiration promoted normalization of mucous gland of bronchus.After laryngectomy, she had been alive without dyspnea but one year after died suddenly by acute heart failure. The cause of acute heart failure was suspected to be based on the complication of relapsing polychondritis.
特定非営利活動法人日本気管食道科学会の論文