New Tracheotomy Alternative Gives Hope

ByABC News via via logo

May 17, 2005 -- -- For years, patients like Dina Hanson who've suffered extensive damage to their trachea -- or windpipe -- have had just one option available to them: a tracheotomy.

The procedure consists of creating a small hole in the trachea and inserting a tube to aid the patient's breathing.

But a new procedure developed by Dr. Eric Genden, a throat expert at the Mount Sinai Medical Center in New York, is giving new hope to patients who believed there was none.

When Hanson went into a diabetic coma, doctors inserted a tube down her throat to help her breathe.

But at the same time, Hanson suffered a dangerous side effect: Her trachea was so badly damaged that she couldn't breathe properly.

She estimates that she underwent some 20 surgeries to repair the damage, but nothing worked and the scar tissue always returned.

"They would take some of the scar damage out, and then go back two weeks later and there was scar there that came back," Hanson said. "So it's two steps forward, one step back."

For Hanson, who loves to sing, it was devastating.

Her only choice was a tracheotomy, which would allow her to take breaths through a tube connected to a small opening in the base of her neck.

While this allowed her to breathe, the tube redirected air that would normally pass through her vocal cords, making it difficult to speak and took away her ability to sing.

"I thought it was going to be terrible," Hanson said. "It was like the end, it felt like this is it, and how can I take care of my son or my family if I can't talk to them?"

But that was not the end, thanks to a new, more effective method for tracheal transplants developed by Genden.

"The patients that come to us are, for the most part, desperate," Genden said. "They're looking for an answer to a problem that is for the most part, unsolvable."

Tracheal transplants, he said, are nothing new -- they've been done for the past century. But they often failed due to infection or further scarring and patients with extensive damage -- more than four inches -- were deemed beyond repair.

These patients traditionally had no choice but to undergo a permanent tracheotomy, but Genden's procedure significantly changes their prognosis.

"This gives them an option for reconstruction where before they had no option," he said

In 2003, Hanson became one of nine patients to undergo Genden's new surgery. His method works because it combines donor trachea cartilage and the patient's own tissue.

In typical transplants, the possibility of rejection, when the body perceives the transplant as an enemy and attempts to destroy it, requires medication. Genden's combination allows patients to live without fear their body will reject the new tissue.

But maybe more importantly, it allows them to communicate normally.

"I think patients like Dina are very distressed. I think a lot are depressed; a lot of them are down," he said. "You have to understand that when patients lose the ability to speak, or the ability to breathe without a tracheotomy, it affects the way they socialize, the way they communicate, and the way they see their family."

For Hanson, the procedure gave her back her life -- singing voice included.

"I sang again with my husband at karaoke and we sang 'Love Shack,' " she said. "It still to me didn't sound like I used to sing, but everybody was very happy that I was able to get my emotions out to people again and we had a big party."

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