Surgeons at Sidra Medicine, a member of Qatar Foundation, have performed a laryngotracheal reconstruction surgery on a baby with a rare throat condition.
Baby Lulwa was born with a laryngeal web and subglottic stenosis. This meant that her upper windpipe was very narrow and her larynx had a thick layer of web-like tissue covering it, making it difficult for her to breathe normally.
Dr Faisal Abdulkader, division chief, Ear, Nose and Throat and Otolaryngology, Sidra Medicine said, “When Lulwa was transferred to Sidra Medicine in late 2019, it was important to get a full picture of her condition so as to plan the right treatment programme. Laryngeal web can sometimes be misdiagnosed for asthma, as the symptoms of raspy breathing and shortness of breath are very similar. Without immediate intervention, the openness of her airway will be at risk.”
During her initial assessments at Sidra Medicine, a laryngoscopy was inserted into Lulwa’s airway to see the extent of the blockage and the thickness of the web-like tissue. Dr Abdulkader and the team reviewed all the options available - minimally invasive and surgery - in consultation with her parents.
Lulwa’s care at Sidra Medicine was handled with the combined expertise of otolaryngology; head and neck surgery; paediatric anaesthesia; the paediatric intensive care unit (PICU); speech and language therapy and child life services.
Lulwa underwent two phases of Laryngotracheal reconstruction surgery. During the first phase, the division of her vocal cord web and a balloon dilatation to her trachea was performed. This helped address the narrowing at her vocal cords however, her trachea needed more definitive surgical reconstruction.
The second stage of Lulwa’s reconstruction surgery involved inserting a small piece of cartilage into the narrowed section of her windpipe to make it wider. This final procedure allowed surgeons to open her airway to its full capacity for her breathe freely and clearly. An endotracheal tube was used as a stent to open the airway. She was then transferred to the PICU for a week to keep her intubated.
Lulwa’s parents said: “During our daughter’s initial assessments, we sought a second opinion with doctors outside of Qatar to confirm whether we were taking the right approach. We were assured when they validated that Sidra Medicine, with its expert team and technologies, was one of the best children’s hospitals in the Middle East to conduct the surgery. We couldn’t be happier to see our beautiful daughter thrive under the care and attention of the staff.”
“Despite the rarity and the complexity of her condition, this was the first time the management of such a case was performed in Qatar without the need for a tracheostomy. It is important to highlight the specialist expertise that we have at Sidra Medicine throughout the entire journey of care for our young patients – from our surgery to paediatric anaesthesiology, through PICU and child life services,” added, Dr. Mansour Ali, chair of paediatric surgery at Sidra Medicine.
