Yonsei Med J.  2014 Nov;55(6):1743-1746. 10.3349/ymj.2014.55.6.1743.

Usefulness of Permanent Tracheostoma in Chronic Brain Injured Patients: A Case Series

• Won YH
• Jeon SY
• Kim HS
• Bae H

• KMID: 2070226
• DOI: http://doi.org/10.3349/ymj.2014.55.6.1743

Abstract

Patients with severe neurological deficit, such as hypoxic ischemic injury, cerebral infarction, and traumatic brain injury, often show comatose mental status and require maintenance of long-term tracheostomy for pulmonary toileting. However, several complications, which are mostly related to the cannula, invariably occur. Permanent tracheostoma is a short, skin-lined, noncollapsing, self-sustaining opening by suturing the denuded skin lining to the margin of the tracheal stoma. This tube-free method is a useful alternative to make long-term airway without tube-related complications in chronic diseases, such as obstructive sleep apnea, and laryngeal cancer, however, it has not yet been reported in chronic brain injured patients. This case report illustrates 3 cases of vegetative patients in our rehabilitation clinic who underwent successful procedure of permanent tracheostoma. Permanent tracheostoma has some benefits associated with the free of tube-related complications, and can be considered as a useful alternative way for chronic brain injured patients with long-term tracheostomy.

Keyword

Permanent tracheostoma; chronic brain injury; tracheostomy; rehabilitation

MeSH Terms

Brain Injuries/complications/*rehabilitation
Humans
Male
Middle Aged
Trachea/*surgery
Tracheostomy/*methods
Treatment Outcome

Figure

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  Fig. 1 A schematic comparison of conventional tracheostomy and permanent tracheostoma and photographys of case 1 patient. (A) A conventional tracheostomy is not covered with skin between tube and stoma, which makes high risk of inflammation and infection due to exposed subcutaneous tissue. (B) A permanent tube-free tracheostoma is covered with skin lining and not contact with tube. (C) A picture of before, (D) after permanent tracheostoma of case 1 patient.

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