Challenges and outcomes of airway surgery in a post‐war low‐resource setting: A case series from Mekelle, Ethiopia

Abstract Objective This study aims to document and analyze the challenges and outcomes of performing complex airway surgery in a low‐resource, post‐war setting in Mekelle, Ethiopia. Methods This prospective case series examines clinical data from five patients who underwent airway reconstruction sur...

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Main Authors: Daniel G. Eyassu, Estephania Candelo, Brhanu H. Asgedom, Katherine P. Wallerius, Shaina W. Twardus, Weston L. Niermeyer, Katerina J. Green, Tejas S. Athni, Joshua P. Wiedermann
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Laryngoscope Investigative Otolaryngology
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Online Access:https://doi.org/10.1002/lio2.70034
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author Daniel G. Eyassu
Estephania Candelo
Brhanu H. Asgedom
Katherine P. Wallerius
Shaina W. Twardus
Weston L. Niermeyer
Katerina J. Green
Tejas S. Athni
Joshua P. Wiedermann
author_facet Daniel G. Eyassu
Estephania Candelo
Brhanu H. Asgedom
Katherine P. Wallerius
Shaina W. Twardus
Weston L. Niermeyer
Katerina J. Green
Tejas S. Athni
Joshua P. Wiedermann
author_sort Daniel G. Eyassu
collection DOAJ
description Abstract Objective This study aims to document and analyze the challenges and outcomes of performing complex airway surgery in a low‐resource, post‐war setting in Mekelle, Ethiopia. Methods This prospective case series examines clinical data from five patients who underwent airway reconstruction surgeries and one patient who underwent total laryngectomy at Ayder Comprehensive Specialized Hospital in Mekelle. Data included patient demographics, airway stenosis etiology and severity, operative details, postoperative outcomes, complications, and hospital length of stay. Ethical approval was obtained from institutional review boards at Mayo Clinic and Mekelle University. Results The study included six patients aged 9–62 years, with surgeries comprising three cricotracheal resections, two tracheal resections, and one laryngectomy. Three reconstructions were for war‐related injuries. Challenges included power outages during surgeries, limitations in medical supplies and equipment, and inadequate perioperative care. Despite these, three patients requiring tracheostomies were successfully decannulated within a year. However, complications such as restenosis, infections, and the need for reintubation were common. Conclusion Airway surgeries in a low‐resource, post‐war setting face significant hurdles, including perioperative care quality, resource limitations, and infrastructure issues. Successful outcomes require multidisciplinary training tailored to local contexts, investments in hospital infrastructure and reliable electricity, and proper perioperative nutrition. This study highlights the need for comprehensive interventions to improve surgical care in such settings. Level of evidence: IV.
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spelling doaj-art-4a2bc548e4cc4c22a9a243a98de051822024-12-23T11:50:35ZengWileyLaryngoscope Investigative Otolaryngology2378-80382024-12-0196n/an/a10.1002/lio2.70034Challenges and outcomes of airway surgery in a post‐war low‐resource setting: A case series from Mekelle, EthiopiaDaniel G. Eyassu0Estephania Candelo1Brhanu H. Asgedom2Katherine P. Wallerius3Shaina W. Twardus4Weston L. Niermeyer5Katerina J. Green6Tejas S. Athni7Joshua P. Wiedermann8Department of Otolaryngology and Head and Neck Surgery Mayo Clinic Rochester Minnesota USADepartment of Otolaryngology and Head and Neck Surgery University of Washington School of Medicine Seattle Washington USADepartment of Otolaryngology and Head and Neck Surgery Ayder Comprehensive Specialized Hospital Mekele EthiopiaDepartment of Otolaryngology and Head and Neck Surgery Mayo Clinic Rochester Minnesota USAUniversity of Virginia School of Medicine Charlottesville Virginia USADivision of Otolaryngology and Head and Neck Surgery The George Washington University School of Medicine and Health Sciences Washington, DC USADepartment of Otolaryngology and Head and Neck Surgery Mayo Clinic Jacksonville Florida USAHarvard Medical School Boston Massachusetts USADepartment of Otolaryngology and Head and Neck Surgery Mayo Clinic Rochester Minnesota USAAbstract Objective This study aims to document and analyze the challenges and outcomes of performing complex airway surgery in a low‐resource, post‐war setting in Mekelle, Ethiopia. Methods This prospective case series examines clinical data from five patients who underwent airway reconstruction surgeries and one patient who underwent total laryngectomy at Ayder Comprehensive Specialized Hospital in Mekelle. Data included patient demographics, airway stenosis etiology and severity, operative details, postoperative outcomes, complications, and hospital length of stay. Ethical approval was obtained from institutional review boards at Mayo Clinic and Mekelle University. Results The study included six patients aged 9–62 years, with surgeries comprising three cricotracheal resections, two tracheal resections, and one laryngectomy. Three reconstructions were for war‐related injuries. Challenges included power outages during surgeries, limitations in medical supplies and equipment, and inadequate perioperative care. Despite these, three patients requiring tracheostomies were successfully decannulated within a year. However, complications such as restenosis, infections, and the need for reintubation were common. Conclusion Airway surgeries in a low‐resource, post‐war setting face significant hurdles, including perioperative care quality, resource limitations, and infrastructure issues. Successful outcomes require multidisciplinary training tailored to local contexts, investments in hospital infrastructure and reliable electricity, and proper perioperative nutrition. This study highlights the need for comprehensive interventions to improve surgical care in such settings. Level of evidence: IV.https://doi.org/10.1002/lio2.70034airway reconstructioncapacity buildingEthiopiaglobal surgeryotolaryngology
spellingShingle Daniel G. Eyassu
Estephania Candelo
Brhanu H. Asgedom
Katherine P. Wallerius
Shaina W. Twardus
Weston L. Niermeyer
Katerina J. Green
Tejas S. Athni
Joshua P. Wiedermann
Challenges and outcomes of airway surgery in a post‐war low‐resource setting: A case series from Mekelle, Ethiopia
Laryngoscope Investigative Otolaryngology
airway reconstruction
capacity building
Ethiopia
global surgery
otolaryngology
title Challenges and outcomes of airway surgery in a post‐war low‐resource setting: A case series from Mekelle, Ethiopia
title_full Challenges and outcomes of airway surgery in a post‐war low‐resource setting: A case series from Mekelle, Ethiopia
title_fullStr Challenges and outcomes of airway surgery in a post‐war low‐resource setting: A case series from Mekelle, Ethiopia
title_full_unstemmed Challenges and outcomes of airway surgery in a post‐war low‐resource setting: A case series from Mekelle, Ethiopia
title_short Challenges and outcomes of airway surgery in a post‐war low‐resource setting: A case series from Mekelle, Ethiopia
title_sort challenges and outcomes of airway surgery in a post war low resource setting a case series from mekelle ethiopia
topic airway reconstruction
capacity building
Ethiopia
global surgery
otolaryngology
url https://doi.org/10.1002/lio2.70034
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