The department of respiratory medicine at Sakra World Hospital covers the entire spectrum of pulmonary problems ranging from the recognition to pharmacologic and interventional treatment. We have specialized expertise with most sophisticated techniques and technology such as fibre optic and rigid bronchoscope to diagnose and treat patients with number of airway problems.
We provide expertise in diagnosis and management of airway problems such as upper, lower, partial, complete, acute and chronic airway obstruction. Sakra is a specialized center for preventive, educational and treatment aspects of asthma, COPD, bronchiectasis and other airway disorders that provide comprehensive services to take care of these patients.
What is an airway problem?
Weakness in the walls of the windpipe which is present at birth is known as tracheomalacia. Underdevelopment of cartilage in the windpipe makes the walls of trachea floppy instead of being rigid, because of which breathing problems begin soon after the birth.
What are the types of airway problems in children?
- Upper airway obstruction at the voice box
- Lower airway obstruction which occurs at the junction of the larynx and narrow passageways
- Partial airway obstruction which allows air to pass partially
- Complete airway obstruction which do not allow any air to pass, breathing is affected
- Acute airway obstruction occurs quickly because of the foreign object
- Chronic airway obstructions which might take a long time to develop or will remain for a long time.
What are the symptoms of tracheomalacia in children?
Both severe and mild symptoms have been observed which include:
- Breathing noises during sleep
- Breathing problems during coughing, crying and feeding
- Infections in upper respiratory tract
- High pitched breathing
- Rattling breaths
How is tracheomalacia treated?
- Close monitoring of the babies with respiratory infections
- Administering antibiotics for infection
- Careful feedings
- Rarely, surgery is required
What is tracheotomy?
A surgical procedure in which direct airway is opened by making a hole in the front part of the neck by making an incision through trachea or windpipe. This hole serves as the location where tracheotomy tube is inserted, which allows the person to breath without the requirement of nose or mouth, and it works as an alternative way of breathing. Tracheomalacia can be corrected by:
- Surgical technique.
- Minimally invasive tracheotomy
When is tracheotomy recommended?
- Severe facial trauma
- Tumors in head and neck
- Inflammation of head and neck
- Angioedema
- Failed orotracheal intubation
How is surgical tracheotomy performed?
As children are anatomically smaller in size, surgery is a challenging task. It would be difficult to open trachea because of the shorter neck and a bigger thyroid gland.
- General anansthesia is used while performing the surgery to numb neck and throat.
- A tentome is used to open the trachea which gives a better view for the doctor to create a hole.
- Tracheal dilators are expanded by placing them at the opening
- To elute the foreign bodies from the larynx, tracheal dilators are used.
- The tracheotomy tube is placed at the hole.
- A tracheotomy tube comes in various size to allow for the better and a comfortable fit.
- To prevent the tracheotomy tube to slip out, a neck trap is connected to face strap.
- To secure the face plate to the skin of the neck, temporary sutures are used.
How is minimally invasive tracheotomy performed?
- At the front of the neck, a small cut is made
- To view the inside of throat, a special lens is inserted through the mouth.
- With the use of the lens, a tracheostomy hole is created to insert the needle into the windpipe.
- In order to accommodate the tracheotomy tube, the hole created is expanded
- To prevent the tracheotomy tube to fall off the windpipe, a neck strap is attached to a faceplate.
What are the precautions which have to be considered after tracheostomy?
- To prevent infection, tracheostomy tube should be regularly cleansed at least twice a day
- The irritation and coughing caused from the mucous of tracheostomy is avoided by adding saline into the tracheostomy tube. Saline has shown to add the moisture content into the tracheostomy tube.
- During healing stage, Patients receive nutrients from a feeding tube which is inserted at the intravenous line
- To clear the secretions from throat, a patient will be asked to learn to use a suction machine.
