Post-intubation tracheal stenosis: How we handled the Situation?
A 34-year-old female was presented with progressive dyspnea for one month. This was accompanied by short breath which lasted for the same period of a month. She has a history of unknown poisoning, for which she was put on a ventilator, following which she had a tracheostomy in April 2023. Shortness of breath is one of the major symptoms of this condition, as the disease becomes progressively chronic, it lasts longer than one month.
Post-intubation tracheal stenosis is the narrowing of the trachea for which tracheostomy is considered when all scopes are ruled out, also considering every complication which can arise post-surgery.
Symptoms for this condition included the following: –
- a) shortness of breath that worsens gradually
- b) stridor i.e., respiratory sounds which resembled wheezing.
This 34-year-old female was taken for dilation of their air tubes using techniques such as bronchoscopy because of the following reasons:
- a) CT scan of the neck and chest revealed the complexity of tracheal stricture. This reduced or narrowed the passage of air such as in the trachea.
- b) Major reason for considering such procedures was the presence of 2 strictures one over the other, revealed in flexible bronchoscopy. Such conditions call for procedures like these.
Diagnosis of tracheal stenosis: –
The team of doctors and experts carried out a special screening of the lady to find out the medical history of the patient as she informed, them she had a history of unknown poisoning.
The tests included the following diagnostic measures:
a) LFT
b) CT scan
c) Chest X-ray
Plan of surgery: –
Dr. Sheetu and the team wanted to perform CTVS surgery which is supposedly an ideal treatment for such conditions, but the patient refused for it in cold. Cardiothoracic and Vascular surgeries are surgeries of the heart, lungs, chest, oesophagus, and major vessels of our body which are affected by certain conditions that lead to abnormal functioning causing difficulties.
Due to lack of consent, another was brought forth as a replacement for surgery which is an ideal replacement for invasive techniques.
The plan included the widening of the tracheal tube using stents that dilated the airway causing troubled breathing.
The team of experts that included pulmonologists, scanning experts, and anaesthesiologists were together performing the entire process to aid relief to the lady.
Dr. Sheetu who is a well-known pulmonologist and chest expert with expertise in procedures such as bronchoscopy, helped her patient to get rid of troubled breathing patterns. She is a renowned health expert in her field with hands-on experience in a lot of surgeries relieving patients with histories of respiratory ailments. With a proper and precise diagnosis, followed by a well-structured treatment plan, her patients are handled well with required and effective treatment plans.
What was done?
For this condition of tracheal stenosis, i.e., narrowed tracheal tube affecting the normal flow of air, we went with a rigid bronchoscope to obtain a clear view of airways and lungs.
The procedure was performed in the presence of anaesthesiologists to relieve the patient from any sort of pain during the process, but safe enough to avoid complications.
This was followed by the removal of unwanted tissues using electrocauterization, which dilated the tracheal stricture. This was followed by the use of CRE balloons for dilating the airway endoscopically. The entire process is well-monitored through the tubes producing a clear view of the air passages.
The dilation procedure is then followed by a self-expansive metallic stent called an SEM stent. The placement of these stents requires control in endoscopic methodology and thus is to be performed by a specialist in the field of such surgeries.
The procedure performed with high precision and efficacy requires monitoring and rehabilitation but does not require them to be admitted to the ICUs.
The female patient was observed for a day and was sent home on the second day of the completion of the procedure. However, regular follow-ups are advised for observing the growth in improvement to such difficulty in breathing patterns.
Conclusion: –
With regards to such non-invasive techniques, it is a blessing to save lives and give extra breaths to the patients owing to their medical ailments that require our efforts for the betterment of their lives.
Dr. Sheetu and the team of health experts brought her life back to normal by bringing the abnormal breathing conditions causing troubled respiratory patterns, back to normal. It is beyond our imaginations sometimes the ways we can find certain problems that appear a dead end.
