Synechiae of the nasal cavity as a manifestation of granulomatosis with polyangiitis: clinical case
Granulomatosis with polyangiitis (formerly called Wegener’s) is an idiopathic systemic necrotic granulomatous polyangiitis, which is clinically manifested by lesions of the organs’ triad: the upper respiratory tract (ears, nose and throat), lungs and kidneys. Early diagnosis of this disease directly affects the damage severity to target organs and disability of patients. To date, immunosuppressive therapy allows to control the symptoms, so we can discuss a chronic relapsing course of this disease. ENT specialists are directly involved in the primary diagnosis of granulomatosis with polyangiitis since the disease manifestation in the head and neck areas occurs in 95% of cases. Commonly, pathognomonic changes affect the sinonasal region, which is manifested by recurrent sinusitis, abundant cortical formation in the nasal cavity, and the development of a saddle nose deformity. Also, given the area of the head and neck, common events arise from the middle and inner ear, subglottic laryngostenosis. The role of the otorhinolaryngologist in the further follow-up of patients with diagnosed granulomatosis is important for controlling the disease signs and improving the life quality of patients. This article describes the manifestations of Wegener’s granulomatosis in the upper respiratory tract using a clinical case.