Скачать или смотреть LONG TRACHEOSTOMY TUBE //LONG SEGMENT TRACHEAL GRANULATION CASE

Age/Sex: 48-year-old male
Diagnosis: Motor Neuron Disease (MND)
Chief Complaint: Breathing difficulty

History
• Known case of Motor Neuron Disease for the last 2 years.
• Underwent tracheostomy 6 months ago due to progressive respiratory muscle weakness.
• Presenting with: Increasing breathlessness and difficulty clearing secretions.
• History of recurrent aspirations due to bulbar involvement.

Examination
• Tracheostomy tube in situ
• Respiratory rate: ↑ (tachypneic)
• SpO₂: Reduced on room air
• Chest auscultation: Conducted sounds present

Investigations
• Flexible bronchoscopy performed via tracheostomy:
• Findings:
• Slough and granulation tissue extending from tracheostomy site up to the carina
• Partial airway narrowing
• No evidence of distal bronchial involvement

Management Plan
• Given the patient’s aspiration risk and airway narrowing, we opted for:
• Long tracheostomy silicone tube placement
• Bypassed the diseased segment
• Reduced airway resistance
• Provided better clearance of secretions

Outcome
• Post-procedure:
• Patient’s breathing improved significantly
• Oxygen saturation stabilized
• Airway now patent
• Planned for regular bronchoscopic follow-up and aspiration precautions

Conclusion

“In a patient with Motor Neuron Disease and airway compromise due to tracheal slough and granulation tissue, a long tracheostomy silicone tube proved effective in bypassing the diseased segment and improving ventilation.”
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