Innovative surgery widens constricted airway, allows patient to breathe freely

UCI Health expert uses minimally invasive treatment for life-threatening condition

Two years and two types of inhalers later, Donna Kindred was still short of breath. Doctors had diagnosed her condition as asthma, but her symptoms were getting progressively worse. She was now gasping for air after taking just a few steps. It was time to get another opinion.

A laryngoscopy revealed that her asthma was in fact subglottic stenosis, a narrowing of the windpipe. This potentially life-threatening condition is caused by scar tissue forming in the trachea, just below the vocal cords. Donna’s airway had narrowed to just three millimeters, less than half the width it should be.

Donna, a Palm Springs resident, was referred to Dr. Sunil Verma, a voice, swallowing and breathing expert with UCI Health.

“Donna’s condition is idiopathic subglottic stenosis, which means the cause is unknown,” said Verma. “This condition is most often found in women between the ages of 30 and 50, who have had children. We don’t know why it happens, it just does.”

Until a few years ago, the standard treatment for subglottic stenosis was surgery that required making an incision below the voice box into the trachea and inserting a stent, or tube made of metal or silicone, in the airway to keep it open.

Verma, assistant professor of head and neck surgery, is a leader in minimally invasive surgical techniques that eliminate the need for scalpels or incisions. He performed an innovative procedure called laser balloon dilation on Donna, which involved inserting an endoscopic laser through her mouth to cut the scar, dilate the airway using a balloon, and apply medicine to help prevent the stenosis from returning. She went home that day.

“UC Irvine Medical Center is one of the few hospitals in Southern California and the only one in Orange County to offer this procedure,” Verma said. “This surgery changed Donna’s life. She went to sleep struggling to breathe and woke up with a whole new airway.”

Subglottic stenosis is a somewhat rare and very challenging condition because it is often misdiagnosed as asthma, COPD or bronchitis. Wheezing, gasping for air and shortness of breath are common symptoms of all of these respiratory ailments.

“Asthma, bronchitis and COPD are lung diseases, which also restrict the ability to breathe normally,” said Verma. “If you are being treated for a respiratory condition and it is not getting any better, my advice is to go see a specialist.”

Verma and Donna were guests on a recent episode of the nationally syndicated television show The Doctors, which featured a film clip of the surgery.

Watch The Doctors episode