At times, there are children who are born pre- term or several weeks before their estimated date of birth. As a result, they could be born with several congenital and syndromic problems. They remain intubated in the neonatal intensive care units for a long time and this increases the chances of them getting airway obstructions (stenosis). These infants are born with several co-morbidities, which significantly complicate and prolong their treatment. Their life expectancy is very often severely reduced.
A recent multi-centric peer reviewed study showed that the incidence of critically ill patients in ICU’s undergoing tracheostomy (an artificial tube passed directly into the trachea – the windpipe) has increased from 8% to 17% with an increase in the incidence of laryngotracheal stenosis by 7%.
In developing countries, there are large number of patients with airway stenosis, though no systematic incidence studies have been carried out. Unfortunately – the complexity of such situations is beyond imagination in under developed and war-affected nations.
Worldwide, vast majority of hospitals are not able to deal with such situations and usually the patients are referred to quaternary clinics for further management. Presently, there are very few established dedicated centres for the management of compromised complex airway stenosis in a child.
The treatment of these difficult conditions is expensive and this is because of long stays of the patients in intensive care units after surgery, multiple endoscopies and the costly support help that are critical in ensuring best results. On an average 150,000 Swiss francs are required to treat ONE such patient. Patients from the European Union EU are covered under the European insurances – albeit needing personal funding for patients residing outside the EU.