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What Are The Factors Considered Before A Tracheostomy Decannulation?

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Posted on Wed, 13 Jan 2016
Question: tracheostomy decannulation
doctor
Answered by Dr. Sumit Bhatti (34 minutes later)
Brief Answer:
Depends on many factors.

Detailed Answer:
Hi,

Thank you for your query.

1. Before decannulation, many factors are considered, such as the indication, current respiratory status, general condition and tolerance.

2. Once decannulation has been decided, a Videolaryngoscopy is done to check the larynx and vocal cords.

3. If all is normal, a partial block is done followed by a complete block of the tracheostomy tube. If this is tolerated well, decannulation can be done.

4. Another way is to progressively decrease the tracheostomy tube size and then try blocking it.

5. A speaking valve also helps in decannulation.

6. The wound is simply pinched and strapped with an adhesive tape.

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
doctor
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Follow up: Dr. Sumit Bhatti (39 minutes later)
my brother is from egypt he lives there he is 19 and he have had the tracheostomy tube done 17 years ago and we dont know doctors said he can remove it when he is 16 he is 19 now is that true?
doctor
Answered by Dr. Sumit Bhatti (19 hours later)
Brief Answer:
Please give more details about his earlier and present condition.

Detailed Answer:
Hi,

Thank you for writing back.

1. He needs an evaluation of the upper airway, whether his vocal cords are XXXXXXX whether there is any aspiration and whether he can breathe normally including chest evaluation.

2. A tracheostomy reduces the respiratory effort by about 50%. Hence to wean him off the tracheostomy will be a longer process as his body has got used to breathing through the tracheostomy tube.

3. Only after this should a trial with blockage of the tracheostomy tube be tried under strict observation.

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
doctor
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Follow up: Dr. Sumit Bhatti (4 hours later)
he has never changed tube in 5 years what are the complications? please advice
doctor
Answered by Dr. Sumit Bhatti (13 minutes later)
Brief Answer:
Please change the tube after inspection and x-rays.

Detailed Answer:
Hi,

Thank you for writing back.

1. Even if it is a metal tube, it should be changed once a year.

2. PVC tubes should be changed every month. Silicone tubes should be sterilised every month (to a maximum of 10 times) and then changed.

3. Complications include blockage of tubes, displacement, injury to the windpipe or foodpipe, stenosis (narrowing), leaching of metals, breakage of tubes, infections and so on.

I hope that I have answered your query. If you have any more questions I will be available to answer them.

Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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What Are The Factors Considered Before A Tracheostomy Decannulation?

Brief Answer: Depends on many factors. Detailed Answer: Hi, Thank you for your query. 1. Before decannulation, many factors are considered, such as the indication, current respiratory status, general condition and tolerance. 2. Once decannulation has been decided, a Videolaryngoscopy is done to check the larynx and vocal cords. 3. If all is normal, a partial block is done followed by a complete block of the tracheostomy tube. If this is tolerated well, decannulation can be done. 4. Another way is to progressively decrease the tracheostomy tube size and then try blocking it. 5. A speaking valve also helps in decannulation. 6. The wound is simply pinched and strapped with an adhesive tape. I hope that I have answered your query. If you have any more questions I will be available to answer them. Regards.