Premature, Low Birth Weight, Baby Sowmya Receives Rare Procedure for Subglottic Stenosis: Coblation and Balloon Dilatation Offer Hope

Hyderabad, 23rd May, 2025: Baby Sowmya's journey to health took a remarkable turn thanks to a groundbreaking medical intervention at Star Hospital. A one-month-old, premature, and underweight (1.5kg) baby Sowmya faced a severe infection leading to breathing difficulties and chest retractions. Following ventilator support, complications arose, revealing a rare condition known as subglottic stenosis. This condition is characterized by a narrow airway passage, posessignificant challenges for the medical team.

Subglottic stenosis is a complex ailment that restricts airflow due to the narrowing of the airway, presenting critical implications for infants like baby Sowmya. In her case, acquired subglottic stenosis stemmed from medical interventions, including incubation and ventilator support. This presented a unique challenge for

Dr. P.V.L.N Murthy, Senior Consultant ENT/Otorhinolaryngologist at Star Hospital.

renowned for his expertise in treating complex airway disorders.

Dr. Murthy explains, "We typically encounter this acquired subglottic stenosis in ventilated infants. Upon examination of the baby here at STAR Hospital, we observed a mere one-millimeter gap in the airway, with the remainder of the subglottic region obstructed by scar tissue. Repairing this area in a small, 40-day-old infant poses significant challenges due to the limited space and the delicate nature of the procedure. Anaesthesia administration is particularly challenging for such a critical and tiny patient. However, our expert anesthesiateam employed apneic ventilation, providing oxygen without the need for a tracheal tube. Through intermittent surgery and anesthesia, we managed the procedure successfully. Coblationtechnology played a pivotal role, in melting the scar tissue and widening the airway. Subsequent use of an airway balloon further dilated the area, ultimately enabling complete repair of the subglottic region. Following the operation, the baby experienced immediate relief from breathing difficulties."

Dr. Murthy said “The subglottic area is already narrow, making intubation impossible. In such cases, we may opt for a tracheostomy to bypass this area, creating a small surgical opening in the trachea to secure the airway before repairing the subglottic stenosis. However, in this instance, we faced a challenge. Instead of resorting to a tracheostomy and stabilizing the airway with an additional surgery, we decided to proceed without it. This decision was made possible by the expertise of our anesthesia team, who successfully maintained anesthesia throughout the procedure. Coblation technology played a crucial role, allowing us to perform the surgery with minimal tissue damage and a bloodless surgical field, making it particularly suitable for delicate airways like those of infants." He further added about the current status of the baby, ‘"Now the baby is like four weeks. Baby is doing well, gained good weight, no distress, voice is clear, and the baby can take the fluids from the mother continuously."

The success of this intervention underscores the importance of advanced medical techniques and skilled practitioners in managing complex paediatric conditions.

For further details on Baby Sowmya's case and similar medical interventions, please contact Dr. P.V.L.N Murthy at Star Hospital.

About Dr. P.V.L.N Murthy: Dr. P.V.L.N Murthy is a seasoned Senior Consultant in ENT/Otorhinolaryngology with over 12 years of experience. Renowned for his expertise in treating complex airway disorders, Dr. Murthy is committed to delivering exceptional care to patients of all ages.