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Throat surgery #2, inconclusive?

Posted Sep 11 2009 4:57pm
ENT diagnosis: no vocal chord paralysis, no laryngeal malatia, extensive swelling and granulomas on the vocal chords and vocal folds. Throughout the procedure under general anaesthesia, Reuben required no respiratory support. The CPAP training has paid off. As said previously, in May, prior to this prolonged period of intubation, his airway was "beautiful". Yesterday's findings:

1. A good looking esophagus and trachea. No problems here.


2. Inflammation in the throat caused by intubation and potentially, reflux.


3. Damaged larynx. Granulomas on the vocal chords, significant swelling of the vocal folds all caused by the ET (ventilator) tube.



ENT procedure: Co2 lasering of granulomas from one vocal chord, not wanting to risk removing the granulomas from both sides of the vocal chords, I believe, to reduce the risk of scar tissue closing the airway completely. So I'm not sure if the other granuloma will just go away or will need to be lasered later (must google).

Reuben is on steroids again to reduce the swelling. The plan is to try extubation in 5-7 days.

Wasn't this good news? although I didn't allow myself to smile throughout. ENT then flipped over the photos and began to write 2 numbers on the back. It dawned on me that these were the contact details for arranging to watch the tracheostomy video. We're still in trach talk if extubation fails.

When the ENT surgeon returned to pick up another patient for a trach (and tried to locate the mum who's sadly never around and leaves me wanting to pick up that baby myself and take him home to love), I clarified "Does Reuben have laryngeal malatia?". He replied that he hadn't seen laryngeal malatia so I guess I'm still wondering if that's conclusive.

Reuben is ferile this morning so we're hoping it's just a temporary thing from the surgery and his temperature will come down.

I've got to admit, having got my head around the gtube and fondoplication, the anatomy of the heart (VSD, PS, CoA, ASD) and ear (cochlea, auditory nerves), the throat itself is a whole other crash course to take. As the advice has been here, just take each day at a time. I'm just hoping the days til Wednesday will fly.
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