Tracheal Surgery Restores Woman’s Ability to Breathe and Speak

Deborah Vorndran, of Fort Wayne, Indiana, doesn’t remember much about March 9, 2023, when she was hospitalized for a bowel obstruction. She knows that on receiving a contrast dye for an imaging procedure, she became nauseated, threw up, and aspirated dye into her lungs.

“Things went downhill from there,” she says. For two months, she relied on intubation and an ECMO life support machine to breathe. She then had a tracheostomy, in which a tube was inserted into her trachea to open an airway, and was discharged to a rehabilitation facility, where she stayed for a month.

“I lost 24 pounds and had to relearn how to walk,” she says. “Before this happened in March, I was very healthy and never even on any prescription drugs. My husband and I used to compete with running on the treadmill.”

When she left the rehabilitation facility, she had grade 4 tracheal stenosis – the most severe level of narrowing in which the airway is completely closed off with scar tissue – and could neither speak nor breathe on her own.

“That’s when our doctor said that we should try Cleveland Clinic,” she says.

After initial consultation, on Oct. 24, Deborah had tracheal resection surgery performed by William Tierney, MD and Rebecca Nelson, MD, laryngologists specializing in airway reconstruction in the Cleveland Clinic Department of Otolaryngology-Head & Neck Surgery.  

“Our group sees a high volume of these procedures annually,” Dr. Tierney says. “Having two subspecialists with our expertise puts Cleveland Clinic in a unique position.” Together, they bring different backgrounds with complementary training and skills to the procedure, he says. “We have developed a really good process.”

During a six-hour surgery, Dr. Tierney and Dr. Nelson removed Deborah’s tracheostomy and scar tissue. They then reconstructed her injured trachea. Even before leaving the operating room, Deborah was able to breathe on her own and to speak.

“Her first words in the operating room were, ‘thank you!’, which really epitomizes how impactful this surgery can be for people,” Dr. Tierney says. Five days later, Deborah left the hospital, breathing independently and speaking in a normal voice – which has been her status ever since.

Deborah on the beach with her granddaughters. (Images Courtesy: Deborah Vorndran)

Deborah’s case is unusual, Dr. Tierney says. “She is an especially good example of someone who came in with a terrible disease state and left with an excellent result. We see two to three patients a week who have had some injury, but only a handful each year who are that severe. Some people also aren’t good candidates for this surgery because they are very sick. Deborah may fall into a minority of people who were otherwise pretty healthy before their medical event.”

For Deborah, the change has been night and day.

“My voice came right back – not quite as strong as it was before,” she says. “That first night after surgery, I called my sister and the kids. It made a world of difference in my outlook on life. I am such a talker!”

Up until then, she focused on living as normally as she could.

“I’m not a down person,” she says. “I am always upbeat, but there were times before the surgery that I was sad that I couldn’t talk. Yet, I still would get on the treadmill, and my husband, John, would hold my oxygen tank for me. I wanted to build myself up for the surgery. One thing that helped me survive it all was that my husband and kids were my cheerleaders, and a nurse friend was at the hospital with me.”

Deborah’s good outcome also can be attributed to her following medical recommendations and embracing recovery even when the future didn’t seem bright, Dr. Tierney says. “In my opinion, she’s done all of the things we asked to rehabilitate. She’s always kept her chin up, even when we met and hope hadn’t yet re-entered the equation. I also want to give a shout-out to our rehab team. It is a partnership.”

He advises that individuals who have a tracheostomy placed and are told they will need it long-term should be evaluated at a national-level tertiary center like Cleveland Clinic. He also is conducting research on minimizing the risk of injuries from breathing tubes.

“We have done a lot of work on that to make it less likely,” Dr. Tierney says, noting that he is preparing for publication of a large research project. “In our research, we have been able to show the characteristics that predispose people to injury. Deborah lost a year of her life. We hope to prevent that situation for other people, including trying to create a national program for prevention.”

Deborah says that beyond Cleveland Clinic’s medical expertise, she is grateful for their human touch. “I was nervous before the surgery, like everyone is, but I felt so comfortable with Dr. Tierney. He said, ‘We gotta’ get Deb back to normal so she can compete with her husband on the treadmill.’ I feel wonderful now and am back to competing with my husband – the treadmill one day, weights the next. I think the world of Dr. Tierney and his whole team. They are so caring, and you don’t always find that.”