Management of Airway Obstruction in Cicatricial Pemphigoid

Lazor, John B.; Varvares, Mark A.; Montgomery, William W.; Goodman, Max L.; Mackool, Bonnie T.

doi:10.1097/00005537-199608000-00020

Cited by 12 publications

(5 citation statements)

References 16 publications

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“…The articles identified from our search included 63 case reports7–58 and 10 case series,24, 59–66 representing 141 patients with laryngeal involvement of MMP. No clinical trials or comparative trials of laryngeal MMP were found.…”

Section: Resultsmentioning

confidence: 99%

Laryngeal mucous membrane pemphigoid: A systematic review and pooled‐data analysis

2010

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Section: Resultsmentioning

confidence: 99%

Laryngeal mucous membrane pemphigoid: A systematic review and pooled‐data analysis

2010

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“…Also known as cicatricial pemphigoid, it is a vesiculobullous condition which primarily affects the oral cavity and eyes. Although rare, there are reported cases in the literature of MMP, causing epiglottic ulceration and oedema [71] or even as a large laryngeal mass encasing the glottis [72]. In both cases, an emergency tracheostomy was performed.…”

Section: Airway Managementmentioning

confidence: 99%

“…In both cases, an emergency tracheostomy was performed. There is some evidence of use of topical mitomycin in preventing laryngotracheal stenosis in cicatricial pemphigoid [71,73].…”

Section: Airway Managementmentioning

confidence: 99%

Pemphigus Vulgaris and Bullous Pemphigoid of the Upper Aerodigestive Tract: A Review Article and Novel Approaches to Management

Hussain¹,

Tanweer²,

Sakagiannis³

et al. 2021

ORL

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Background: Autoimmune bullous diseases are rare conditions characterized by blistering of the skin and mucous membranes. The 2 commonest forms are pemphigus vulgaris and bullous pemphigoid. The oral cavity or oropharynx may be the initial site of presentation or often the only site involved. Summary: These conditions are often misdiagnosed or overlooked leading to poorer patient outcomes. Due to the chronic nature of these conditions and the systemic effects of treatment, there is a significant associated morbidity and mortality. As such, an understanding of the fundamentals of autoimmune bullous diseases is vital to those working in otolaryngology. The mainstay of management in both conditions is topical and systemic corticosteroids. There is also a role for immunomodulating and non-steroidal anti-inflammatory drugs as adjunct or alternative therapies. Surgical intervention may be required to protect the airway. Often multimodality treatment is required involving multidisciplinary input from otolaryngologists, oral surgeons, dermatologists, and rheumatologists. This review article will highlight the aetiology, pathology, clinical features, investigations, and management of both pemphigus vulgaris and bullous pemphigoid including recent advances in management.

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“…It was rst de ned as a separate pathological condition by Thorst 5 in 1911 and was termed benign mucous membrane pemphigoid in 1953 by Lever. 3 In 1980, Fisher 6 was the rst to describe laryngeal involvement in pemphigoid, and Drenger 7 was the rst to report airway obstruction in the disease in 1986.…”

Section: In 1988mentioning

confidence: 99%

“…Supraglottic scarring is treated effectively with the carbon dioxide laser. Whilst excision in the acute period is not recommended, 5 repeated division of laryngeal scar tissue may be necessary to stabilize the airway. Use of adjuvant mitomycin seems to reduce the severity of stenosis and lengthen the symptom-free interval.…”

Section: Treatmentmentioning

confidence: 99%

Mucous membrane pemphigoid: nasal and laryngeal manifestations

et al. 2003

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Mucous membrane pemphigoid (MMP) is a sub-epithelial blistering disease that primarily involves mucosal surfaces but may also involve the skin. Clinically, it appears as vesiculobullous lesions of the oral cavity and eyes, but other tissues such as the nasopharyngeal and laryngeal mucosa can also be affected. Ultimately, scarring and airway stenosis may occur. The condition should be managed by a multidisciplinary team led by a dermatologist. Immunosuppressive therapy forms the mainstay of treatment, with surgery having both a diagnostic role and a use in the treatment of complications such as airway obstruction. There must be a low threshold of suspicion for laryngeal involvement in this group of patients, so that prompt action can be taken. Once laryngeal stenosis has occurred repeated endoscopic laser excision of scar tissue can be used to maintain an adequate airway. Adjuvant use of mitomycin-C can be used beneficially in the treatment of laryngeal complications of MMP.

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Management of Airway Obstruction in Cicatricial Pemphigoid

Cited by 12 publications

References 16 publications

Laryngeal mucous membrane pemphigoid: A systematic review and pooled‐data analysis

Laryngeal mucous membrane pemphigoid: A systematic review and pooled‐data analysis

Pemphigus Vulgaris and Bullous Pemphigoid of the Upper Aerodigestive Tract: A Review Article and Novel Approaches to Management

Mucous membrane pemphigoid: nasal and laryngeal manifestations

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