Patient records
Name: Maria Siregar
Age: 34
Nationality: Indonesia (Jakarta)
Diagnosis: Severe subglottic tracheal stenosis after endotracheal intubation (the stenotic segment is about 2.5 cm long, with an inner diameter of about 3 mm at the narrowest point, accompanied by cartilage ring destruction).
Treatment Hospital: Shanghai Pulmonary Hospital (Endoscopy Center/Thoracic Surgery Department)
When Maria sang "Jasmine Flower" in a slightly hoarse yet incredibly beautiful voice on the other end of the video call, the medical service team at Sanshan Medical Companion had tears in their eyes. This song was the melody of life restarting, and the highest praise for all our efforts. But for this moment, we had accompanied her through the darkest hour of her race against death.
Maria was a well-known singing teacher in Jakarta, her world made up of musical notes. However, a life-saving intubation following an accident left her with a devastating aftereffect—severe subglottic tracheal stenosis. At its narrowest point, it was only 3 millimeters wide. She couldn't lie flat, couldn't speak a complete sentence, and every breath was accompanied by a sharp hissing sound; she was always at risk of suffocating from a single spit of phlegm. In Southeast Asia, she underwent five balloon dilation procedures, but the stenosis, like a spring, would retract after each dilation, until finally, local doctors told them they were "powerless to help."
When our team received this case , we knew it was not just a technical task, but a race against death. Our case manager immediately activated the "critical case green channel," targeting the Endoscopy Center of Shanghai Pulmonary Hospital, known as the "Whampoa Military Academy" of interventional pulmonology in China. We worked through the night to compile Maria's CT 3D reconstruction images and surgical records, and urgently coordinated a multidisciplinary consultation involving interventional pulmonology, anesthesiology, and thoracic surgery.
During the online consultation, the director of the endoscopy center astutely pointed out the crux of the problem: "This is not a simple membranous stenosis. The CT scan shows that the cartilage rings have collapsed and been destroyed. Simple dilation is ineffective; a stent must be implanted to reshape the airway." This judgment directly determined Maria's fate. In the operating room, the atmosphere was extremely tense. Due to the severity of the stenosis, Maria's blood oxygen saturation dropped to 70% after anesthesia induction. However, the surgeon calmly inserted a rigid bronchoscope, instantly eliminating the risk of suffocation through this "lifeline." Subsequently, under high-frequency ventilation, the doctors precisely removed the scar tissue with a laser and measured the length of the stenotic segment. Considering Maria's young age and the high location of the lesion, the doctors decided to use a silicone T-tube to preserve her voice. The moment the T-tube was precisely implanted, the respiratory waveform on the monitor returned to stability, and everyone breathed a sigh of relief.
Post-surgery, our case manager played a crucial role. Because the T-tube required regular cleaning and nebulization, we recorded detailed bilingual nursing videos for her and created an illustrated home care manual. After returning home, Maria uploaded photos of her throat and respiratory rate daily via our app. Our medical team reviewed these uploads regularly and provided feedback. Six months post-surgery, when a follow-up assessment showed her airway remodeling was successful and the T-tube could be removed, she excitedly sang. That song was the most beautiful melody of life we had ever heard.