Bronchoscopic Management of Tracheobronchial Stenosis Secondary to Granulomatosis with Polyangitis: A Case Report

Airway manifestations of Granulomatosis with Polyangitis (GPA) can be varied ranging from simple mucosal inflammation to critical tracheobronchial stenosis. Management of critical airway stenosis secondary to GPA is challenging. Significant airway compromise might require immediate evaluation and endoscopic or surgical intervention. Endoscopic interventions either in the form of balloon dilatation, electrosurgery, laser therapy, intralesional corticosteroid injection, topical application of mitomycin C, endoluminal spray cryotherapy or stent placement, remain the mainstay of treatment especially in patients who are deemed high risk and not a candidate for reconstructive surgery. We describe a case of tracheobronchial stenosis secondary to GPA, presenting with respiratory insufficiency requiring mechanical ventilator assistance on tracheostomy, successfully managed by endoscopic intervention combining bronchoscopic balloon dilatation and airway stent placement.