抄録
12 cases of decanularion problems, including 9 children and 3 adults, were clinically and systematically investigated.
These were discussed from the view points of:
1) Original disease (pretracheotomy).
2) Why tracheotomy was done?
3) Tracheotomy method.
4) Endoscopic observation.
5) General physical status and clinical lab. tests.
6) Tracheo-cutaneous fistula.
7) Post tracheotomy complication.
8) Macroscopic appearance of Tracheostoma.
9) Size and material of tracheotomy tube.
etc.
Tracheotomy technique should be born in one's mind any time and one should be well trained to be able to perform the most suitable and correct tracheotomy.
Cricothyroidotomy must be avoided.
Removal of tracheotomy ring and rings must be minimum in size, so that trachea supports its antero posterior sustain.
The obturator is advised to be used each time at tracheotomy tube change.
Tracheocutaneous fistula should be removed by the usual manouver, as soon as patient shows no sign of dyspnea with full corking.
Laryngoplasty and Tracheoplasty should be considered for chronic canulated patient with poor tracheal support, constant granulation woozing and tendency to laryngeal stenosis.
