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Obstructive suprastomal granulation tissue following percutaneous tracheostomy
1Department of Otolaryngology, Royal North Shore Hospital, Sydney, New South Wales.
Anaesthesia and Intensive Care
|January 13, 2000
Summary
Percutaneous dilatational tracheostomy can lead to granulation tissue complications, particularly when the cricoid cartilage is involved. This may cause difficult decannulation, requiring specific management strategies.
Area of Science:
- Otolaryngology
- Surgical Procedures
Background:
- Percutaneous dilatational tracheostomy (PDT) is a common alternative to open surgical tracheostomy.
- While generally safe, PDT can lead to short-term and long-term complications.
Purpose of the Study:
- To report on complications arising from PDT involving the cricoid cartilage.
- To highlight challenges in decannulation due to granulation tissue formation.
Main Methods:
- Case series presentation of four patients.
- Review of clinical course and management of decannulation difficulties.
Main Results:
- Four cases of difficult decannulation were identified.
- Exuberant obstructive granulation tissue was the cause of decannulation difficulty in all cases.
- Percutaneous tracheostomy involved the cricoid cartilage in all reported cases.
Conclusions:
- Involvement of the cricoid cartilage during PDT may increase the risk of granulation tissue formation.
- This granulation tissue can lead to significant decannulation problems.
- Careful technique and awareness of potential complications are crucial for PDT.