Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Remedy For Swelling When On Trach And Ventilator
Question: My son is an ALS patient with a trach and a ventilator. When we are using the catheter suction, it seems as though there is an obstruction or a swelling that doesn't allow the tube to go down beyond the end of the cannula. Would you have any suggestions to enable us to bypass the swelling/scar tissue? Would a longer trach tube be of any help? Has anyone ever used a 'stent' for this particular problem? We would appreciate any input you experts might suggest.
Brief Answer:
Endosocpy/CT Neck+Chest. Hyperflex Portex Bivona TT, Airway Balloon
Detailed Answer:
Hi,
Thank you for your query.
1. It should be possible to pass a flexible endoscope through the tracheostomy to visualize the obstruction.
2. This obstruction could be granulation tissue or a stenosis among many possibilities. How long has he been on the Tracheostomy Tube? Does he have any other symptoms of airway blockage?
3. A CT Scan of the Neck & Chest with virtual bronchoscopy may be done for an accurate assessment.
4. A Silicone Portex Bivona Hyperflex Trachesotomy Tube (TT) or a Customized TT will be better than a stent. (Dumon-Novatech).
5. If there is a stenosis, an Inspira Air -Acclarent airway dilatation balloon will help. If there is granulation, it can be reduced.
6. You may consult Dr. XXXXXXX Levine MD regarding Balloon Airway Dilatation at the XXXXXXX Nasal Sinus & Sleep Center and the XXXXXXX Clinic Foundation’s Head and Neck Institute. You may also consult Dr. XXXXXXX F. Castellanos at UAB Medical West, Alabama.
7. If you can upload a CT Neck+Chest and/or endoscopic images, I can suggest further treatment options.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Endosocpy/CT Neck+Chest. Hyperflex Portex Bivona TT, Airway Balloon
Detailed Answer:
Hi,
Thank you for your query.
1. It should be possible to pass a flexible endoscope through the tracheostomy to visualize the obstruction.
2. This obstruction could be granulation tissue or a stenosis among many possibilities. How long has he been on the Tracheostomy Tube? Does he have any other symptoms of airway blockage?
3. A CT Scan of the Neck & Chest with virtual bronchoscopy may be done for an accurate assessment.
4. A Silicone Portex Bivona Hyperflex Trachesotomy Tube (TT) or a Customized TT will be better than a stent. (Dumon-Novatech).
5. If there is a stenosis, an Inspira Air -Acclarent airway dilatation balloon will help. If there is granulation, it can be reduced.
6. You may consult Dr. XXXXXXX Levine MD regarding Balloon Airway Dilatation at the XXXXXXX Nasal Sinus & Sleep Center and the XXXXXXX Clinic Foundation’s Head and Neck Institute. You may also consult Dr. XXXXXXX F. Castellanos at UAB Medical West, Alabama.
7. If you can upload a CT Neck+Chest and/or endoscopic images, I can suggest further treatment options.
I hope that I have answered your query. If you have any more questions I will be available to answer them.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
