PMC9911262_01
Pharyngeal findings of the case.. (A) Pharyngeal ulcer and stenosis before treatment. (B, C) The pharynx and larynx after administration of infliximab. An ulcer is completely resolved, but stenosis progresses. During the surgery after exposure using FK-WO retractor (D), partial resection of stenosis (E), and completion of the expansion of the pharynx (F). The pharynx two days (G) and one year (H) after the surgery.
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FIG1
Video laryngoscopy revealed a circumferential oropharyngeal stenosis with a large ulcer at the level of the epiglottis (Figure 1A). After the third dose of infliximab, the disease seemed controlled based on the resolved sore throat for the first time since the onset of incomplete Behcet's disease and the disappearance of the pharyngeal ulcer on laryngoscopy (Figures 1B, 1C). To dilate the pharynx, the intubation tube was evacuated forward using an FK-WO retractor, but the supraglottic area was not visible due to stenosis (Figure 1D). An electric needle knife (KD-600, Olympus, Tokyo) was used to incise the thin mucosa at the stenosis, which spontaneously opened by tension using the FK-WO retractor (Figure 1E). Finally, we confirmed the pharyngeal cavity had been enlarged (Figure 1F) and terminated the surgery. Postoperative laryngeal edema was mild (Figure 1G). One year postoperatively, restenosis of the pharynx did not occur (Figure 1H), and the patient was able to have a normal diet without any dietary restrictions.