Successful Surgical Treatment for Subglottic Stenosis Associated with Relapsing Polychondritis : A Case Report

Relapsing polychondritis (RP) is a rare autoimmune disease characterized by recurrent inflammation of the cartilage throughout the body. Airway involvement is a critical prognostic factor that is often managed with tracheostomy as symptomatic treatment. However, reports on surgical interventions for airway stenosis associated with RP are limited. We herein report a case of successful surgical management of subglottic stenosis associated with RP. A 23-year-old woman presented with a low-grade fever and dyspnea. She was diagnosed with RP following a thorough examination and treated with corticosteroids and immunosuppressants. Despite these treatments, her symptoms persisted because of the subglottic stenosis. Surgical intervention was deemed necessary, and the procedure included tracheostomy followed by a cervical external approach to remove scar tissue and deformed cartilage. The preserved tracheal mucosa and residual cartilage were sutured to expand the subglottic airways. Postoperatively, sufficient subglottic dilation was confirmed and the laryngotracheal fistula was closed in a staged manner. After closure, the patient experienced a significant improvement in exertional dyspnea, allowing gradual reduction of corticosteroids and immunosuppressants. This case highlights the importance of surgical planning to address both the severity of airway obstruction and inflammatory activity in RP-associated subglottic stenosis. Strategies to achieve sufficient airway expansion and a staged approach to tracheostomy closure are critical for achieving optimal outcomes.