{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T21:39:07Z","timestamp":1774647547154,"version":"3.50.1"},"reference-count":56,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"national institute on deafness and other communication disorders","doi-asserted-by":"publisher","award":["1R01DC018567, 1K23DC014082, and R21DC017225"],"award-info":[{"award-number":["1R01DC018567, 1K23DC014082, and R21DC017225"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Subglottic stenosis (SGS) is a known complication of granulomatosis with polyangiitis (GPA). We investigated the impact of medical and surgical interventions on the surgical dilation interval and characterized patients with glottic involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A retrospective chart review of patients with GPA\u2010associated SGS was performed from 2010 to 2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary academic medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The impact of medical and surgical interventions on dilation interval was assessed. The prevalence of glottic involvement was assessed, and clinical characteristics and outcomes were compared with patients without glottic involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 39 patients with GPA\u2010associated SGS were analyzed. Dilation intervals in patients receiving leflunomide (n = 4; median, 484\u00a0days; 95% CI, 405\u20101099) were greater than in those not receiving leflunomide (median, 155\u00a0days; 95% CI, 48\u2010305; <jats:italic>P<\/jats:italic> =. 033). The surgical technique used did not affect dilation interval. Patients with glottic involvement (n = 13) had a greater incidence of dysphonia (13\/13 vs 15\/26 [58%], <jats:italic>P<\/jats:italic> =. 007) and a shorter dilation interval with involvement (median, 91\u00a0days; interquartile range, 70\u2010277) versus without involvement (median, 377\u00a0days; interquartile range, 175\u20101148; hazard ratio, 3.38; 95% CI, 2.26\u20105.05; <jats:italic>P<\/jats:italic> &lt;. 001). Of 13 patients, 8 (62%) did not have glottic involvement on first presentation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although GPA is classically thought to affect the subglottis, it also involves the glottis in a subset of patients. These patients have greater complaints of dysphonia and require more frequent surgery. Systemic therapy may increase dilation intervals. In this preliminary study, patients taking leflunomide demonstrated an improvement, highlighting the need for further study of immunosuppression regimens in the treatment of GPA\u2010associated SGS.<\/jats:p><\/jats:sec>","DOI":"10.1177\/01945998211004264","type":"journal-article","created":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T04:23:55Z","timestamp":1618287835000},"page":"845-853","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Factors Affecting Dilation Interval in Patients With Granulomatosis With Polyangiitis\u2010Associated Subglottic and Glottic Stenosis"],"prefix":"10.1002","volume":"165","author":[{"given":"Lena W.","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine Johns Hopkins University Baltimore Maryland 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