Saving a Severed Larynx

BaggageAlisha Alfred was at work on the Spirit Airlines baggage crew at George Bush Intercontinental Airport as they started to offload luggage from an arriving flight. “I was reaching for a bag and my scarf got stuck in the conveyor belt. I was sucked underneath, pulled up and left hanging with my feet off the ground,” says Alfred, who was 19 when the accident occurred in November 2018. “The crew reversed the belt and got me out quickly. They were trying to give me water, but I couldn’t swallow.”

The scarf left scratches and bruises on her neck but no indication of the extent of internal injury. When Alfred arrived by ambulance at the Level I Memorial Hermann Red Duke Trauma Institute at Memorial Hermann-Texas Medical Center, Ron Karni, MD, was called in to assess her injury. Dr. Karni, who is skilled at otolaryngologic trauma, is chief of the Division of Head and Neck Surgical Oncology at Memorial Hermann-TMC and an associate professor who holds joint appointments in the Department of Otorhinolaryngology-Head and Neck Surgery and the Division of Oncology at UTHealth.

“Miss Alfred had severe blunt trauma to the neck with significant stridor. Her airway was badly damaged, making intubation dangerous,” Dr. Karni says. “We established an airway with tracheostomy and when I opened her neck and saw the damage, I was horrified. She had a collapsed larynx, a fissure through the thyrohyoid membrane, and a complete separation of the upper and lower parts of the larynx, which was severed just above her vocal cords. The cartilage above her vocal cords was floating unattached. When I saw the severity of damage to an organ critical for voice, breathing and swallowing, it was hard to imagine that even a young woman would bounce back.”

In surgery, Dr. Karni worked to repair multiple areas of the larynx, carefully putting cartilage and lining back in place. After the surgery, Alfred spent 2.5 weeks in the hospital with a tracheostomy and feeding tube, both of which were removed by the end of February. She returned to work for the airline in March.

“I recovered quickly, much faster than I expected,” she says. “I’m very thankful to Dr. Karni for saving my life.”

“Miss Alfred is a tenacious young lady,” Dr. Karni says. “She came in with a life-threatening injury – one that I’ll never forget. She was unable to eat for several months and today she can swallow normally. When I first saw her I thought she might lose the use of her larynx and live with a trach and feeding tube for the rest of her life. She has made a remarkable recovery after a devastating injury that could have been fatal.”

 

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