ENT surgeons perform surgery to help child breathe normally after 7 yrs

The 10-year-old boy, Tarun (name changed) from Bhubaneswar, Odisha, was suffering for the past 7 years following an accidental ingestion of acid as a toddler, leading to severe aero digestive injury and scarring. He was on assisted breathing through the tracheostomy tube all these years.
Representative image
Representative image

CHENNAI: MGM Healthcare, a multi-speciality quaternary care hospital in the heart of Chennai, announced the successful outcome of a complex airway surgery performed on a child by the team headed by Prof. Dr. Sanjeev Mohanty, Senior Consultant & Head, Institute of ENT, Head & Neck Surgery, MGM Healthcare.

The 10-year-old boy, Tarun (name changed) from Bhubaneswar, Odisha, was suffering for the past 7 years following an accidental ingestion of acid as a toddler, leading to severe aero digestive injury and scarring. He was on assisted breathing through the tracheostomy tube all these years. The supportive family members explored all possibilities to cure the child, but with no results. The entire upper airway was scarred and stenosed above and below the vocal cords in the laryngeal airway tract. The only method of breathing possible was through the tracheostomy tube, which needed to be changed very frequently.

The child has been hospitalised 55 times over the past 7 years in various premier institutes of repute across the length and breadth of the country. All methods of surgical treatment under general anaesthesia proved futile, and the resultant sequelae proved even more catastrophic, leading to more fibrosis of the airway. The family had lost hope and, in despair, came to MGM Healthcare Chennai. After being appraised about the prevailing work culture of the skilled clinicians and their proven credentials along with good patient outcomes, the family hoped for a positive result.

After a purposeful radiological and endoscopic assessment, a confirmed diagnosis of pharyngeal stenosis along with supraglottic, subglottic, and upper tracheal stenosis was arrived at. Robust planning and staged surgeries were required to address the complicated, scarred airway judiciously. A proper family counselling was offered in view of the risks involved in the supra major surgical treatment strategies. A staged surgical effort over four weeks of in-patient hospitalisation resulted in enviable outcomes for the child, who is breathing freely through the nose now like any other human being.

Prof. Dr. Sanjeev Mohanty, Senior Consultant and Head, Institute of ENT, Head & Neck Surgery, MGM Healthcare, explaining the entire procedure, said, “This complex surgery needed a lot of innovation intra-operatively. The child underwent endoscopic assisted PCTR (partial cricotracheal resection) with anastomosis using autograft rib cartilage to reconstruct the defective airway. This was only possible after releasing the upper airway stenosis using a harmonic scalpel. The repeated use of laser and other energy devices in the same area earlier, during previous hospitalisations, had made the tissues completely dysfunctional. Hence, there was a need for out-of-the-box thinking, in dealing with the delicate airway. The rib harvested integrated well with the tissues, and after a period of monitored observation, he was finally discharged from the hospital with smiling faces all around. This would not have been possible without the constant cooperation of the team of anaesthesiologists, led by Dr. Kishore.”

The staff and management of MGM Healthcare are elated to have helped a boy come out of the trauma of breathing through a tube. Many such patients are still breathing through the tracheostomy tube due to a lack of proper medical attention and surgical expertise for such complex clinical scenarios. Such patients can reach-out to the experts at MGM Healthcare to overcome their illness and lead a normal, happy life.

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