Young Boy’s life saved by a Balloon
This is an interesting and motivating story of a young 21year old boy, who came from a remote village in Uttar Pradesh for his treatment in Mumbai. He had been suffering from fever, cold, cough and voice change for two months from July 2021. He kept visiting nearby physicians and surgeons but had no relief. His condition worsened and he could no longer eat or drink.
He came to consult Dr Binhi H. Desai, a practising ENT and Voice surgeon (Laryngologist) at Desai Orthopedics and ENT clinic and Apex Superspeciality Hospital, Borivali west, Mumbai. The patient had a nasogastric feeding tube and was coughing incessantly. He had lost weight and had become weak. Stroboscopic evaluation with Olympus Flexible system (World’s best technology) was performed at Apex Superspeciality Hospital, Borivali west. This facility (Olympus) is available only at this hospital in the western suburb. The larynx (voice box) was severely inflamed (refer to image 1). Sputum was sent for microbiological evaluation. It came as a bacterial infection for which he received the appropriate treatment. The patient showed improvement and the feeding tube was also removed. Gradually over two months, he started developing breathlessness which became so severe that he could not even tie his shirt. He developed a fear of dying due to breathlessness. He was afraid, he would not survive if he had an attack and hence, he started staying in a hospital. He again visited Dr Binhi H. Desai. At that time, he was in severe respiratory distress. Saturation on the oxygen cylinder was 88 per cent. He was immediately admitted for a detailed evaluation and to know the exact cause of his breathlessness, Dr Binhi H. Desai did an Endoscopic evaluation of airways with Laryngol-Bronchoscope (Flexible and Rigid) under general anaesthesia. He had developed severe narrowing of the windpipe(trachea) measuring 8 cm in length. It was starting at the level of vocal folds (voice box) going below into the windpipe (total length of the windpipe is 10-12cm). The narrowing was the widest above and it tapered down to pinpoint with a diameter of just 3mm (The normal diameter of the windpipe is 20-25mm). His previously inflamed vocal folds had healed with scar formation. Multiple tissue specimens were taken for microbiological and pathological evaluation (refer to images 2, 3 and 4).
This required urgent surgery otherwise it could be fatal.
Dr Binhi H. Desai performed a highly challenging procedure of Tracheal Balloon dilatation (images 5,6) under Thrive anaesthesia. The anaesthesia technique was also very challenging. In this, narrowed trachea with opened endoscopically with a balloon three times in the same setting. The surgery is very challenging as it is associated with complications and can also cause death on the table. The surgery was successful (refer to image 7 showing the completely opened windpipe). Immediately after the procedure, the patient further showed complete relief in his symptoms of breathlessness.
His tissue report came as tuberculosis. Thus, he had a very rare presentation of primary tuberculosis of the trachea(windpipe). He was immediately started on anti-tubercular treatment.
Gradually he resumed his routine activities.
After the intensive phase (two months) and completion of anti-tubercular treatment. check Laryngol-Bronchoscopy of airways under short anaesthesia was done to access the previous site of surgery. He showed excellent healing.
Presently, the patient is under regular follow-up. He has returned to his home town and is doing all his regular activities without any fear.
This is an inspiring and motivating story of a young boy who would not have survived had he not come at the right time to the right doctor. This also is a story of deep faith and trust instilled by the patient in his treating doctor.
In the end, we want to conclude by saying that any symptoms such as voice change, breathing difficulty or swallowing difficulty requires a detailed assessment by a Laryngologist (ENT surgeon specializing in voice, swallowing and airways). These difficulties can severely affect your quality of life and can occasionally become fatal. Hence, timely help from a trained professional can go a long way in improving your health and life.