A spectrum of head and neck manifestations in granulomatosis with polyangiitis - how can we grade the disease?
Eliza Brozek-Madry
Medical University of Warsaw, Poland
: J Otol Rhinol
Abstract
Granulomatosis with polyangiitis (GPA) is a challenging trans-disciplinary disease. It requires the cooperation of many specialists and in most cases involves head and neck region, especially nose and paranasal sinuses. Treatment is usually tailored to the extent of disease and organs affected by the disease. The aim is to describe the extent of GPA in head and neck computed tomography and nasal endoscopic examination with a focus on sinonasal disease and concomitant ENT areas and to submit a grading system in GPA patients with sinonasal changes. Study enrolled 68 patients with GPA (study group) and 70 patients with CRS (control group). The study group involved 23 men and 45 women. Patients’ age ranged between 16 and 82. The sinonasal changes in computed tomography were evaluated with Lund-MacKay scoring system but also included nasal cavity mucosal changes, bony and cartilaginous changes and external nose deformity. Other ENT changes included ear abnormalities with fluid or granulomatous changes, skull base inflammatory tumors, laryngeal stenosis and others. The results will be presented in patients with GPA divided into localized and systemic form of disease, c-ANCA positive and c-ANCA negative disease, acute and remission phase of GPA. We believe that this work will show the spectrum of head and neck manifestations in GPA and will help understanding the role of imaging in diagnosing and follow-up of GPA patients in order to establish the indications for radiologic evaluation and avoid unnecessary imaging.
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