Mumbai – 21-year-old boy, who came from a remote village in Uttar Pradesh for his treatment in Mumbai. He had been suffering from fever, cold, cough and voice change for two months from July 2021. He kept visiting nearby physicians and surgeons but had no relief. His condition worsened and he could no longer eat or drink.

Giving more information on this Dr. Binhi H. Desai, practicing ENT and Voice surgeon (Laryngologist) at Apex Superspeciality Hospital, Borivali said,” The patient had a nasogastric feeding tube and was coughing incessantly. He had lost weight and had become weak. Stroboscopic evaluation with Olympus Flexible system (World best technology) was performed at Apex Superspeciality Hospital, Borivali west. This facility (Olympus) is available only at Apex Hospital in western suburb. Larynx (voice box) was severely inflamed and Sputum was sent for microbiological evaluation. It came as a bacterial infection for which he received the appropriate treatment. The patient showed improvement and the feeding tube was also removed. Gradually over two months, he started developing breathlessness which became so severe that he could not even tie his shirt. He developed fear of dying due to breathlessness. He was afraid he would not survive if he had an attack and hence, he started staying in a hospital. He again visited Dr Binhi H. Desai. At that time, he was in severe respiratory distress. Saturation on the oxygen cylinder was 88 percent. He was immediately admitted for a detailed evaluation and to know the exact cause for breathlessness. “

Dr. Binhi Desai did an Endoscopic evaluation of airways with Laryngo-Bronchoscope (Flexible and Rigid) under general anesthesia. He had developed severe narrowing of the windpipe(trachea) measuring 8 cm in length. It was starting at the level of vocal folds (voice box) going below into the windpipe (total length of windpipe is 10-12cm). The narrowing was widest above and it tapered down to pinpoint with a diameter of just 3mm (Normal diameter of windpipe is 20-25mm). His previously inflamed vocal folds had healed with scar formation. Multiple tissue specimens were taken for microbiological and pathological evaluation. This required urgent surgery otherwise it could be fatal.”

Dr. Binhi H. Desai performed a highly challenging procedure of Tracheal Balloon dilatation (images 5,6) under Thrive anesthesia. The anesthesia technique was also very challenging. In this, narrowed trachea with an open endoscopic method with a balloon three times in the same setting. The surgery is very challenging as it is associated with complications and as it can also cause death on the table. The surgery was successful. Immediately after the procedure, the patient showed complete relief in his symptoms of breathlessness.

His tissue report came as tuberculosis. Thus, he had a very rare presentation of primary tuberculosis of trachea(windpipe). He was immediately started on anti-tubercular treatment. Gradually he resumed his routine activities. At completion of intensive phase (two months) and completion of anti-tubercular treatment. check Laryngo-Bronchoscopy of airways under short anesthesia was done to access the previous site of surgery. He showed excellent healing. Presently, the patient is under regular follow-up. He has returned to his home town and is doing all his regular activities without any fear added by Dr. Binhi H. Desai.

Apex Group of Hospitals is a chain of Hospitals managed and run by expert Medical Professionals with experience of 25 years. Currently Apex group of Hospitals manages more than 350+ beds and provides qualitative healthcare services to the people of Mumbai and surrounding areas. Apex Hospitals is located in Borivali, Kandivali & Mulund.

By Rekha