Friday, June 7, 2019

Dinesh Kamath's Editorial 'Hat’s off to Velankar and his team' that was published in In New Bombay


Hat’s off to Velankar and his team
A senior ENT Professor Haritosh Velankar and his team from D Y Patil hospital and research centre department of ENT, Nerul in Navi Mumbai performed a surgery for Laryngotracheal stenosis and succeeded in helping a patient to breath normally and regain his voice after surgery.
The doctor and his team performed the surgery on the 41-year-old patient, who had met with a road traffic accident 5 months back and he was unable to breathe normally through the nose and had lost his voice due to Tracheal stenosis. He is now able to breathe normally through his nose and also got his voice back.
What is Laryngotracheal stenosis? Laryngotracheal stenosis refers to abnormal narrowing of the central air passageways. This can occur at the level of the larynx, trachea, carina or main bronchi. In a small number of patients narrowing may be present in more than one anatomical location.
The most common symptom of laryngotracheal stenosis is gradually-worsening breathlessness (dyspnea) particularly when undertaking physical activities (exertional dyspnea). The patient may also experience added respiratory sounds which in the more severe cases can be identified as stridor but in many cases can be readily mistaken for wheeze. This creates a diagnostic pitfall in which many patients with laryngotracheal stenosis are incorrectly diagnosed as having asthma and are treated for presumed lower airway disease. This increases the likelihood of the patient eventually requiring major open surgery in benign disease and can lead to tracheal cancer presenting too late for curative surgery to be performed.
The optimal management of laryngotracheal stenosis is not well defined, depending mainly on the type of the stenosis. General treatment options include: Tracheal dilation using rigid bronchoscope, Laser surgery and endoluminal stenting and Tracheal resection and laryngotracheal reconstruction.
Hat’s off to Haritosh Velankar and his team for successfully performing this extremely difficult surgery and helping the patient regain his voice.

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