Tracheal Service

Imagine running a 100-metre sprint and then trying to breathe through a straw. For children suffering from long segment tracheal stenosis, this is what trying to breathe normally can feel like.

Children born with very narrow windpipes due to this condition suffer breathing difficulties and often die. The surgery to correct this has historically been very difficult and where surgeons have little experience in this rare condition, results are not always good.

A new service of designated experts at Great Ormond Street Hospital (GOSH) has produced better results.

The Tracheal team

The Tracheal service at GOSH, led by Mr Richard Hewitt, is a group of health professionals that have been brought together to provide a range of expertise. The team includes specialists in ear, nose and throat (ENT), interventional radiology, intensive care, cardiothoracic surgery and physiotherapy.

Since it was formed in 2000 the tracheal service has become one of the largest and most successful services in Europe and a world leader in the field.

The surgical technique the team use is called slide tracheoplasty which involves making cuts into the narrowed part of the trachea, which can sometimes be only a few millimetres wide, and sliding the two sections over each other until the part of the trachea that is normal width is reached.

Martin Elliott, Professor of Cardiothoracic Surgery, who led the team until August 2016, said: "Traditionally children with long segment tracheal stenosis have been managed by individual specialists who can only see a tiny number of such cases during the course of their careers.

"Now that GOSH has been designated as a National Centre, we are able to concentrate our expertise and provide not just one specialist but also many who take an interest in this and whose skills overlap to provide an efficient, well-informed and up-to-date service.

"We have trained each other to carry out a number of skills so that provided we can get children in to hospital there should be no delay in management, and we meet regularly as a multidisciplinary team to make treatment plans, care pathways and to communicate with referring hospitals and patients and their families.

"By seeing a relatively large number of such patients we are able to contribute research to the world’s literature and influence the way in which care of these patients is undertaken worldwide. We have already demonstrated good results and improved efficiency and intend to continue in this way."

The service has secured funding from the National Specialist Commissioning Advisory Group (NSCAG) allowing this vital service to continue its good work.