Hyderabad, Aug 20: Doctors at KIMS Cuddles, Kondapur, have successfully treated a 28-day-old infant who was critically ill with severe breathing difficulty caused by narrowing of the airway, helping the baby breathe normally without the need for a tracheostomy.
The details of the challenging case were shared by Dr Priyanka Valluri,Consultant ENT Surgeon, and Dr Aparna, Regional Director, Neonatology -Academics and Research, KIMS Cuddles and Head of Department, Neonatology, KIMS Cuddles, Kondapur, who treated the infant.
The baby was brought to the hospital with severe respiratory distress, chest retractions and noisy breathing. According to the doctors, the infant had been unable to breathe immediately after birth and required ventilator support for seven days. The baby had subsequently received treatment for pneumonia, pulmonary hypertension and cardiac problems.
At the time of admission to KIMS Cuddles, the infant was in a critical condition. During an emergency attempt to secure the airway, doctors encountered significant difficulty in placing the breathing tube. While a 3 or 3.5-size tube would normally be expected for a baby of this age, only a 2.5-size tube could be passed, raising suspicion of significant airway narrowing.
Further evaluation in the operation theatre revealed Grade 2 subglottic stenosis, a narrowing of the airway just below the vocal cords.
The medical team performed endoscopic balloon dilatation to open the narrowed airway. A specialised 6-mm balloon was carefully used to dilate the stenotic segment. The procedure was performed three times using a controlled technique, following which the airway opened adequately and air could pass freely.
“Treating such a young infant was particularly challenging because of the extremely small airway, the baby’s age and the presence of other medical problems. Our objective was to restore the airway while avoiding a tracheostomy. Following balloon dilatation, the airway opened sufficiently and the baby was able to breathe naturally,” said Dr Priyanka Valluri.
The infant was subsequently monitored under the supervision of Dr Aparna, Senior Neonatologist, and Dr. Vishwanath Nandyala consultant neonatologist and paediatrician made a good recovery. The baby was successfully discharged after stabilisation.
The doctors said that subglottic stenosis in infants can cause serious breathing difficulties and may require urgent intervention when the narrowing is severe. Endoscopic balloon dilatation can, in appropriately selected cases, help restore the airway and avoid more invasive procedures such as tracheostomy.
The successful treatment involved the coordinated efforts of the NICU team, paediatricians, ENT specialists and neonatology team at KIMS Cuddles, Kondapur.