Trachea
Tracheal Strictures or Stenosis
Tracheal stenosis, including subglottic stenosis, is constriction or narrowing of the trachea. In the majority of cases, it develops when the trachea of a patient gets injured after prolonged intubation or from the surgical opening of the trachea. It can also be a result of someautoimmune disorders like sarcoidosis, amyloidosis, and polychondritis), or bacterial and fungal infections.It causes noisy and difficult breathing and is alife threatening condition.
Our surgical team has many years of experience in treating this condition. We use a variety of techniques for tracheal stenosis such as Bronchoscopic Tracheal Dilation, Tracheal Resection and Reconstruction, Tracheobronchial Airway Stent, and Laser Bronchoscopy.
The treatment is always individualized with the help of diagnostic tests such as chest X-rays, Bronchoscopy, Dynamic 3D Chest CT-scans, Computed tomography (CT) with 3-D reconstructions, Pulmonary laboratory studies, Ultrasound, Magnetic resonance imaging (MRI), and Pulmonary Function Tests.
Tracheal Tumours or Trauma
These are rare and therefore experience in dealing them is imperative.We are one of the handful of centres in this country which has the experience & the expertise in tackling these intricate cases
The options available are many and may include:
- Tracheal Resection and Reconstruction: During this procedure, the surgeon will remove the trachea’s constricted section and then rejoin the lower and upper sections.
- Bronchoscopic Tracheal Dilation: The surgeon may opt for the widening of the trachea, either with a surgical instrument known as tracheal dilators or with a balloon. This helps the surgeon diagnose the cause of the stenosis if it is still unknown.
- Laser Bronchoscopy: Lasers may be used by the surgeon for removing the scar tissue that is responsible for the stenosis.
- Tracheobronchial Airway Stent: The surgeon may use a tracheal stent (a tube made out of silicone or metal) and place it in the airway so that it keeps it open.
Surgical removal of the tumour is the preferred choice of treatment if the patient has a noncancerous (benign) or cancerous (malignant) tumour that involves less than half of the trachea. However, it can be a complex and specialised procedure. This is primarily because the supply of blood to the trachea is easily damageable and delicate. Therefore, it is important that the patient selects a qualified and experienced team to improve the chance of a successful outcome.
Tracheo-Oesophageal Fistula
Tracheo-Oesophageal Fistula (TEF) is a condition in which there is an abnormal connection between the food and wind pipe leading to coughing during eating and severe chest infections leading to permanent lung damage.It can happen after other surgical procedures or trauma.
Surgical repair of a TEF is an elective procedure. It consists of division of the fistula, suture of the esophagus and trachea and protection of the suture lines with a buttressed muscle flap. TEF repair is a complex and challenging procedure, requiring competence and experience which our team has, having treated more than 100 of these rare cases. Surgical management yields excellent long-term results, and it should be considered the first-line treatment for this condition. Definitive fistula closure occurs in about 90–95% of the cases.In failed cases, alternative endoscopic techniques are used.
Tracheomalacia
Tracheomalacia is a severe health condition that occurs when the cartilage of the trachea, or the windpipe, failed to develop fully or is weak. This makes breathing difficult as the cartilage is unable to keep the windpipe fully open during the course of breathing.
Based on our sizable experience, we can perform a comprehensive diagnostic examination and guide you on the future course of treatment. This may involve tests such as CT scan, Video Barium swallow study, Airway fluoroscopy, bronchoscopy, and Magnetic resonance imaging (MRI) and then followed by treatment options like external stenting, internal stenting, or tracheal plication or support manouvres.