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Опубликовано: 02.02.2021

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Опубликовано: 01.02.2021

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Опубликовано: 29.01.2021

Doctors of SPbSPMU managed to restore the lumen of the larynx to a three-month-old child

Unique operation allowed the baby with scarred laryngeal stenosis to avoid imposition of a tracheotostomy and begin to breathe fully. >>>

Опубликовано: 28.01.2021

Doctors of SPbSPMU managed to restore the lumen of the larynx to a three-month-old child

Unique operation allowed the baby with scarred laryngeal stenosis to avoid imposition of a tracheotostomy and begin to breathe fully.

A boy named Bogdan was born in Nizhny Novgorod. The baby was born prematurely – at 28 weeks-and weighed only 990 grams.

 

– From the first minutes of his life, he was on an artificial lung ventilation. And when he finally started to breathe on his own, he was breathing very hard and noisily, – mother Yulia said.

The symptoms were caused by a complication of long-term ventilation – scar stenosis of the larynx. The lumen of the respiratory tract narrowed down to two millimeters. The child suffered from hypoxia, did not gain weight, and any SARS could end fatally for him.

Such a condition would be an absolute indication for the imposition of a tracheostomy – an additional hole in the trachea that allows breathing to bypass the stenotic area. But during the telemedicine consultation, it was decided to transfer the little patient to the SPbSPMU. Specialists of the Pediatric University applied an innovative method of treatment, which made it possible to avoid setting a tracheostomy. 

The child underwent endoscopic laryngoplasty with balloon dilation. The surgeon first cut the edges of the scar membrane with a laser, and then expanded the lumen of the larynx with a balloon to the required diameter.

At the time of the operation, the child was 3 months old, he weighed 3.5 kilograms.

 

– Our department has been developing methods of reconstructive surgery of the larynx for many years. But this case has become our new stage – patients of this age and weight have not yet had such operations in Russia, – said Maria Zakharova, an otorhinolaryngologist, associate professor of the Department of Otorhinolaryngology at SPbSPMU.

She also noted that this intervention was performed endoscopically, without external incisions. Therefore, the child will not have a scar.

 

– The peculiarity of the operation is also that it requires stopping the patient's breathing. The exposure lasts about a minute with saturation control. Therefore, the coordinated actions of the surgeon and the anesthesiologist-resuscitator are of great importance here. Any inaccuracy or timeliness of our actions could cost the patient's life. I cannot fail to note the highly professional work of the anesthesiologists-Olga Murashova, Andrey Vagin, Yevgeny Grechko and our nurses, – Maria Zakharova added.

After the operation, Bogdan quickly went on the mend. He used to eat through a probe and almost did not gain weight, now he switched to the usual feeding regime for his age and has already gained one and a half kilograms. Yulia and her baby celebrated the New Year and Christmas at home, in Nizhny Novgorod.

Methods of reconstructive surgery of the larynx at the Department of Otorhinolaryngology of SPbSPMU began to develop more than 20 years ago, on the initiative of the outstanding pediatric otolaryngologist Professor Eduard Tsvetkov. This work continues today – already under the leadership of the current head of the department, Pavel Pavlov.

The priority of restoring the laryngeal lumen in post-intubation stenoses of the sub-vocal region using endoscopic laser laryngoplasty with balloon dilation also belongs to the Pediatric University.

SPbSPMU performs about 80 laryngotracheoplastics a year, about half of them are performed for cicatricial stenosis.

Date of publication: 28.01.2021

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