A 33 year old with 21 years psychological dependence on tracheostomy who was successfully decanulated with a simple method: A case report

Abstract

Background: Psychological dependence on tracheostomy is ubiquitous among children and very young. Case: We report a case of a 33year old who had tracheostomy for recurrent respiratory papillomatosis 21years ago, Efforts at decannulation through simple and surgical methods failed leaving her on a permanent tracheostomy and psychological dependency for over 2 decades The patient presented to our clinic and following evaluation, it was realize that apprehension and loss of self confidence was a major factor. she was engaged in medical,social and psychological counseling prior to this 4th trial at decannulation,when it was realized she was stable enough and psychologically ready. A simple decannulation method focusing mainly on close monitoring of vital signs, especially oxygen saturation rather than somatization features of patients due to exaggerated anxiety and fear which appears to be largely a factor in the previous failed attempt at decanulation. interestingly, the patient tolerated the decanulation trial and final decannulation. she has been stable and off tracheostomy for the past 6months