A Remarkable Recovery From an “Unthinkable” Accidental Strangulation

As part of the baggage crew at a local airport, Alisha Alfred was offloading luggage from an arriving flight, as usual, when the unthinkable happened.

“I was reaching for a bag when my scarf got caught in the conveyor belt. I was sucked underneath, pulled up and left hanging with my feet off the ground,” said 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 visible scratches and bruises on her neck, but there was no indication of the extent of internal injury. When Alfred arrived by ambulance at the Red Duke Trauma Institute at Memorial Hermann-Texas Medical Center (TMC), Ron Karni, MD, was called in to assess her injury. Dr. Karni, who specializes in 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 McGovern Medical School at UTHealth.

“Miss Alfred had severe blunt trauma to the neck with significant stridor (wheezing). 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 saw how horrific the injury really was. 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 repaired multiple areas of the larynx, or voice box, carefully putting cartilage and lining back in place. After the surgery, Alfred spent weeks in the hospital with a tracheostomy and feeding tube. To everyone’s surprise, she recovered faster than expected. Her tubes were removed within three months and she returned to the airline in March 2019.

Alfred said she’s happy to be able to speak and swallow as normal – something many of us take for granted on a daily basis.

“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.”

The ENT specialists affiliated with Memorial Hermann provide comprehensive medical and surgical care and treatment for conditions of the ear, nose and throat. For more information on the conditions treated, or to schedule an appointment, click here.


  1. What a wonderful story this was! I know Dr. Karni from having my own surgery one year ago, and he is the best! I wanted to ask, though, about the scarf she was wearing at the time of her accident, and has the airline in question sought to have more stringent requirements on clothing, or anything else that may pose a safety hazard? I’m glad it all ended well..

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