October 13, 2010
School of Medicine, Kochi
In the recently concluded Kerala ENT conference, Dr. Bini Faizal of the Amrita Department of ENT, won the best video presentation award for her video that demonstrated the surgical repair of tracheo-esophageal fistula.
Tracheo-esophageal fistula or TEF is an abnormal communication between the trachea and the esophagus.
These two, the trachea and the esophagus, are placed next to each other; both go through the chest cavity. The former carries air to the lungs and the latter carries food and saliva to the stomach.
“In case of an abnormal communication between the two, the airway and the food passage tubes, (the trachea and the esophagus respectively), instead of being parallel, become ‘H’ shaped,” explained Dr. Bini.
The abnormal communication results in food entering the airway leading to aspiration, lung infection and associated life-threatening complications. These fistulas are usually congenital.
“Acquired TEF can occur secondary to malignant disease, infection, ruptured diverticula and trauma,” stated Dr. Bini.
Dr. Bini’s award-winning video presentation demonstrated the repair of tracheo-esophageal fistula in a 58-year-old patient.
“The patient had recurrent pneumonia following a tracheotomy,” shared Dr. Bini. “While eating, he would suffer from bouts of cough.”
“Routine investigations were performed on him and he had received treatment for nearly three years without his condition improving. This was before he came to Amrita.”
“Our tests detected air in the cervical esophagus; this led me to perform further investigations. The barium swallow test proved that he was, in fact, having a tracheo-esophageal fistula. This was causing the mixing up of food and air in both the tubes resulting in infection. The solution was the surgical repair of the fistula.”
Dr. Bini elaborated on the procedure.
“A long incision on the left side of the neck was followed by a dissection between the trachea and esophagus. The recurrent laryngeal nerve, which is required for moving the vocal cord, was identified and kept safely out of the surgical field. A tube of 2 cm in diameter was found to be responsible for the abnormal communication between the trachea and the esophagus. This was separated and sutured carefully with absorbable sutures. A muscle flap was kept between the trachea and esophagus to ensure that recurrence did not occur.”
Dr. Bini Faizal joined Amrita in 2005. Currently serving as Clinical Associate Professor, she heads the second unit at the Department of ENT. She has published several papers on topics in head and neck surgeries, rhinoplasty and endoscopic surgeries.
We congratulate Dr. Bini on this achievement.