gms | German Medical Science

GMS Current Posters in Otorhinolaryngology - Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNOKHC)

ISSN 1865-1038

Wegener's granulomatosis of the head and neck – our experience

Poster Rhinologie

  • corresponding author Petar Kolev - Ministry of Interior Medical Institute, Sofia, Bulgaria
  • Stefan Stoyanov - Ministry of Interior Medical Institute, Sofia, Bulgaria
  • Svetla Vasileva - Ministry of Interior Medical Institute, Sofia, Bulgaria
  • Slavena Adamova - Ministry of Interior Medical Institute, Sofia, Bulgaria

GMS Curr Posters Otorhinolaryngol Head Neck Surg 2017;13:Doc045

doi: 10.3205/cpo001599, urn:nbn:de:0183-cpo0015996

Published: April 26, 2017

© 2017 Kolev et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



The aim of our poster is to present several cases of Wegener’s granulomatosis (WG) patients with head and neck manifestations including epistaxis, nasal crusting, prolonged sinus infections with atypical microbiological causes and nasal polyposis.

Materials and methods: These WG patients were referred to our clinic in 2016 for evaluation on the account of their complaints. Among the used methods were full ENT examinations, CT scan of neck and mediastinum, fibrolaryngoscopy, serological testing for ANCA antibodies.

Discussion/conclusion: WG is an idiopathic systemic inflammatory disease typically presenting with vasculitis affecting the upper and lower respiratory tracts and the kidneys. The classical histopathologic features include granulomatous inflammation, necrosis, and/or vasculitis. The initial symptoms typically involve the ENT region. The nose and sinuses are the most frequently affected sites in the head and neck.

The differential diagnosis of ENT disease includes chronic infections (e.g., tuberculous, fungal, and syphilitic), malignancy (e.g., lymphoma), sarcoidosis, Churg-Strauss syndrome. The differential diagnosis of septal perforations associated with WG includes sarcoidosis, cocaine use, SLE, extranodal nasal lymphoma, lymphomatoid granulomatosis (LYG), and excessive use of intranasal corticosteroids.

WG is commonly associated with PR3-ANCA and is highly responsive to treatment with GC and cytotoxic agents. Local treatment for disease involving the head and neck region is often necessary. Empiric experience has led to recommendations to maximize upper airway hygiene to minimize obstruction from crusts and other debris, and diminish colonization with infectious agents.

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