tracheotomy comments and others
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tracheotomy comments and others

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Posted by sleepsurgeon on August 16, 2009 at 18:33:57:

The discussion on tracheotomy was really aimed at pointing out that no treatment is always 100% successful. Tracheotomy is the best treatment for sleep apnea, but it doesn't always completely eliminate ALL of the hypopneas and flow limitations. I think the discussion is really too technical for the audience here, but I will try to explain it. First, even with a trach, there is still respiration from the nose and mouth. A trach tube is typically either a #4 or #6, which is much smaller than the dimension of the trachea. It is small enough to allow for it to fit in the trachea, but also allow for air the flow through the nose and mouth so the person can speak and funtion normally during the day when the trach tub is plugged. The tube is opened at night, but again, there is still respiration through the nose and mouth and some flow limitation still exists through the upper airway. There obviously can be either central, mixed or obstrutive events even with a trach. The RDI of 20 or so after a trach is uncommon but can happen. The point is not to look at what is remaining but look at how much improvement can be achieved.

I do want to make a comment on burning sensation of the lower lip/chin. It is called dysthesia and is rare. Dysthesia needs to be managed aggressively and followed closely to limit the risk of it becoming a permanent problem, which is possible.

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