Granulation tissue

[jem]

Hi!,
My son has granulation tissue problems with his Tracheostomy tube. He needed to have a rigid Broncoscopy to laser out granualtion tissue that had almost surrounded his Trach Tube within three weeks of his original Tracheostomy. We are now facing the same or similar problem about four weeks later. Will know more tomorrow. We are using standard #6 Fenestrated Trachea tubes. Has anyone heard of an allergic or adverse reaction to plastic Trachea Tubes that would cause this type of growth so quick?

[twintotwin]

Is it possible not all of the tissue was removed the first time? Is the granuloma in the same exact place as the one removed 3 weeks ago?
My son has had 4 surgeries for the same reason. One more to go this Tues.

[sandra]

We have not had that experience but I wanted to welcome you to the board. I hope the granulation tissue doesn't come back again.

[cariaad]

Hi Welcome to the board! When Alli was originally trached she had a lot of problem with granulation tissue. What our dr told us was basically that granulation forms as the body's response to the foreign object (in this case, the trach tube). Some people's body's always generate a lot of tissue trying to get rid of the object, some become accustomed to it (Alli has) and others never have a problem, or have a problem at a g tube site but not trach, or vice-versa. It's just the body's natural response. ALli went thru lasering probably every 4 months in the beginning, but hasnt needed any in a long time. How old is your son? A 6 fr is a large trach and if it's fenestrated we were told they seem to generate more granulation (no idea of why it would be different). Keep us informed and maybe we can help you figure things out! Deb

[Kaylie]

Hi,
My grandaughter has had her trach since she was 2 months old,she is now 21 months.We started noticing a granuloma around her stoma,as soon as we brought her home from the nicu,her former Ent told us it was no big deal that when she was close to decan, she would have this removed but it was no big deal, but it is a big deal, because now it is in her airway occluding and growing as we speak,so ive been searching the net and talking with other families with similar issues and especially when its occluding,i have come to find it needs to be gone, but i to think each Ent does things differently, I guess because we recently switched Ent we are definetly going to have it removed he told us its extremely large and occluding her airway just abou totally. But the other said let it go, .Please do what u feel is best, but be cautious too.Hope this helps. take care

[jem]

Hi Again, Â*and thanks for your replies. Â*Specifically, our son our son is in a coma (car Accident) had a tracheostomy on August 31, replaced again on Sept 7, ( #8 cuffed Shiley) since that time he was reduced to a # 6 Solid, non-cuffed, # 6 Fenestrated, and two # 4 Fenestrated. This all ocurred over a twenty four day period. Â*During that time, we discovered that during the 5 day period he was on the #6 fenestrated Trachea, he was being deep suctioned using the fenestrated canulus versus the suction canulus, this causes the suction canulus to go through the fenetration opening versus going down the trach tube. Â*This was evident by the blood in his secretions during this five day period. Â*I guess I'm trying to find out if this is more of a problem that would cause the excess granulation tissue versus his aversion to plastic demonstrated by all his catheters that continued to need replacement during his intensive care stay in the hospital. Â*The resulting granulation tissue was found to encircle 3/4 of his trachea and extended past the end of the trachea tube. Â*A rigid Broncospy was performed and removed most of the granulation tissue. Â*

After we brought him home for recovery we discovered that after three weeks, once again the granulation tissue was growing into his fenestration hole. Â*After returning him to the hospital, the granulation tissue was not as prominent but had already grown into a hump adjacent to his fenestration opening with another spot slightly below his trachea tube. Â*While he is still in the hospital scheduled for another replacement, we are searching for expertise or experience with anyone who knows of or has heard of anyone with adverse reactions to plastic tracheas. Â*The doctors are looking at other styles of tracheas. Can anyone offer any insight into our dilema and yes our son has also already had two bouts of Tracheaitis - Thanks

[twintotwin]

JEM- I'm really sorry your family is going through all of this, especially your son. I will keep him in my prayers.
I don't know about the reaction to the plastic causing the granulomas, but anything is possible. Have you tried using any of the Bivona trachs, they are made of silicone rather than the rigid plastic in the Shileys.
Like I said in my earlier post, my son was full of granulomas. Now his twin is growing his first one ever, around the outer stoma. I hope it doesn't go as far as surgery again for us.
I don't have experience with the fenestrated tubes so I can't comprehend the problem fully. Is there a particular reason why they went the fenestrated way instead of just staying cuffed?

May I ask about your son? How old is he? How long has he been in the coma? How long is he facing?
I've met 2 kids in comas at our rehab hospital, who both came out of the comas with just minimal affects. Just lots of PT, OT and ST coming his way when he wakes (hopefully soon?).

Hugs to you and your family,

~Kerry
http://www.tracheostomy.com/iB_html/non-cgi/emoticons/rose.gif

[jem]

twintotwin,
He's 17, senior year, Admitted on August 1, with GSC3 coma, currently Ranch Amigos scale 3 going into scale 4, probably 1 - 1 1/2 year rehab. Severe head sheer trauma, Not alot of brain damage but needs to wake up. Primary damage in Brain Stem RAS center. Doctros believe once he starts to wkae up he will do well. Alot of work at home to care for him.

[twintotwin]

Oh, that sounds like great news! http://www.tracheostomy.com/iB_html/non-cgi/emoticons/rose.gif I will be praying for him to wake up soon.

[jem]

Has anyone heard of granulation tissue growing past the length of the trach tube and encircling it almost all the way ???

[cariaad]

Once it starts growing, granulation will go wherever it has room to expand. I have heard of using a sterling silver trach for people who cant tolerate plastics/silicones. Ask your dr about them. I would also question the need for any type of deep suctioning. It seemslike it can cause more harm than good. I hope things begin to work out for you. We'll be praying yor son wakes up soon. Deb