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Q: medical ( Answered,   0 Comments )
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Subject: medical
Category: Health > Alternative
Asked by: amc1990-ga
List Price: $25.00
Posted: 14 Jun 2003 08:58 PDT
Expires: 14 Jul 2003 08:58 PDT
Question ID: 217259
Medical
I have a friend who has had throat cancer, as a result of the
radiation and chemo his airways are blocked from the formation of scar
tissue.  How do I research alternitives to a tracheotomy?  Alternive
medicine
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Subject: Re: medical
Answered By: clouseau-ga on 14 Jun 2003 12:15 PDT
 
Hello amc1990,

Thank you for your question.

Do note the disclaimer at the bottom of the page:

"Important Disclaimer: Answers and comments provided on Google Answers
are general information, and are not intended to substitute for
informed professional medical, psychiatric, psychological, tax, legal,
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endorse, and expressly disclaims liability for any product,
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any opinion expressed in answers or comments. Please read carefully
the Google Answers Terms of Service."

That being said, I researched alternatives for you.

A Non-Surgical Alternative to Tracheotomies 
http://www.public.asu.edu/~ender/Projects/Medical/am.trach.html

" Sunday, April 16, 1995

    Polio-era machine helps modern patients breathe easier 

    WASHINGTON - Brad Smith was turned into a speechless invalid
overnight when his doctor drilled a hole in his throat to pump air
into his disease-weakened lungs.

    His doctor didn't know there was an alternative. 

    Now a New Jersey physician is out to change that, sewing up
patients' tracheas and helping them breathe again with a simple
polio-era machine unearthed from a museum.

    "A week ago, I couldn't breathe on my own for five minutes, and
today I've been fine for five hours and back at work," said Smith, a
State Department terrorism specialist with Lou Gerhrig's disease.
"People like me are being put through a chamber of horrors and there's
no need."

    Neuromuscular diseases such as Lou Gerhig's, muscular dystrophy or
paralysis weaken chest muscles until victims can no longer breathe
easily or cough to clear their lungs of dangerous mucus.

    Typically, these patients get a tracheotomy - a tube inserted
through a hole drilled in the throat so air can be pumped in and
secretions suctioned out. The opening is vulnerable to lethal bacteria
and patients routinely get pneumonia. Often, they can't speak.
Constant care to keep the tubes open forces many into nursing homes.

    There is a noninvasive alternative that few doctors offer,
contends Dr. John Bach of the University of Medicine and Dentistry of
New Jersey. The key is a 1952 machine called the Cof-flator that, when
held to the mouth, sucks air from the bronchial tubes to induce a
cough that patients can't force unaided.

    Once patients can clear their lungs, they can breathe with
standard oxygen masks or with an easily learned inhaling technique,
said Bach, who travels the globe to push noninvasive respiratory
care..."

Although this appears to be a non-invasive alternative, I am not sure
that it would work where airways are blocked from scar tissue. But it
might be worth investigating.

This cached paged at PennHealth has bit of pertinent information:
http://216.239.39.100/search?q=cache:EtFKEh2WZLAJ:www.pennhealth.com/health/phys_forum/pto/nov_dec02/voice.html+tracheotomy+%2Balternative+%2Bscar+-sleep&hl=en&ie=UTF-8

"...Scarring of the Airway

When patients have narrowing or scarring of the airway due to an
injury, the traditional treatment method involves inserting a
permanent tracheotomy. Instead, otorhinolaryngologists at the PENN
Center for Voice open the scar and reline it with new tissue (from the
mouth or the skin) that prevents the scar from reforming. Dr. Blumin
recalls one patient who had a tracheotomy placed when he was in his
teens due to a bizarre accident. Twenty years later Dr. Blumin
performed corrective surgery and the patient now speaks normally with
no tracheotomy..."

So, there may be a surgical alternative to remove the scar tissue and
avoid a tracheotomy. You may wish to contact the University of
Pennsylvania Health Department.


EMedicine has an interesting article on tracheal stents which may and
may not be a solution in this particular case, but is worth reading
and asking your physician about:
http://www.emedicine.com/ent/topic593.htm

"...The word stent is derived from Charles B. Stent, a British dentist
who practiced in the late 19th century. Stent developed material that
was used for dental impressions and, later, to support skin grafts.
Today, the word stent refers to material that supports some form of
tissue against collapse. Most often, stent describes devices that
maintain the lumens of tubular organs.

In 1965, Montgomery described the use of silicone prostheses for
tracheal stenting. Surgeons in other subspecialties, such as
gastroesophageal, genitourinary, and vascular, developed stents that
were and are useful in expanding lumens in those areas. This evolution
increased the interest of otolaryngologists to develop stents for the
larynx and tracheobronchial tree...

...Stenting for tracheal lesions varies from palliative, to curative,
to stabilization while a reconstructive effort heals. Frequently, in
adults, primary cancer of the tracheobronchial tree or cancer from the
head, neck, or chest that extends into the tracheobronchial tree can
cause lumen compromise and airway obstruction. The intraluminal
component can be removed with laser, mechanical debulking,
electrocautery, branchytherapy, photodynamic therapy, or cryotherapy.
A stent then can be placed to maintain the airway lumen following
debridement to counteract collapse or edema. Alternatively, stents can
be placed that help compress any lesion extending into the trachea or
bronchi, without the need for debulking. Stents have been used
successfully to palliate patients with inoperable bronchogenic cancer,
primary tracheal tumors, and metastatic malignancies. Placing a stent
in a patient with a terminal illness allows that patient to breathe
comfortably and prevents death from asphyxiation..."

Do read the entire article.


The Cleveland Clinic addresses laser alternatives:
http://www.clevelandclinic.org/otol/laryn/laser.htm

Although it addresses speaking disorders, it might be applicable to
removing scar tissue for easier breathing without a tracheotomy.

"Laser Cordotomy 

Opening the Airway…Speaking and Breathing Easier with Laser Cordotomy

Paralysis of your vocal cords affects more than your ability to speak;
it also restricts your breathing and turns any physical activity into
a struggle for air. When vocal cords or folds are immobile due to
trauma, disease, arthritis or other causes, they become “fixed” in
position less than one-eighth of an inch apart, a space too small for
easy breathing.

A new laser procedure that expands the airway is now offered by
otolaryngologists (physicians specializing in the treatment of ear,
nose, and throat disorders) in the Cleveland Clinic Voice Center. This
procedure, known as laser cordotomy, can significantly improve your
ability to breathe while maintaining vocal quality, and is available
at only a handful of medical centers nationwide...

...Traditional or Conventional Treatment
Traditional surgical techniques used to treat vocal cord paralysis
have some serious consequences. One technique focuses on removing some
of the cartilage of the larynx to open up the airway. Because of early
postoperative swelling, this procedure also requires a tracheotomy, a
temporary opening in the windpipe. A tracheotomy allows you to breathe
and retain a serviceable voice, but it creates other problems,
including the risk of infection. Another traditional treatment option,
surgically pinning aside one vocal cord to create an expanded airway,
results in improved breathing but leads to a breathy (weak) voice.

An Improved Technique
Laser cordotomy offers appropriate patients an alternative to these
traditional surgical techniques. This innovative procedure permits
breathing without a tracheotomy and without removal of cartilage. Just
as important, it also allows you to maintain a good quality voice by
preserving the most significant vocal fold relationships..."

I searched further for information on tracheal scar removal.

IVillage has an article about reoccurring tracheal scar tissue, even
after multiple sugeries:
http://www.ivillagehealth.com/experts/ent/qas/0,,242110_192981,00.html

"I have a condition called "idiopathic progressive subglottic
stenosis." I was diagnosed with asthma for eight years, and it wasn't
until last year when I had great difficulty breathing that the doctor
discovered a "web" of scar tissue growing over my trachea. The scar
tissue continues to grow for no apparent reason. I have laser surgery
every three to four months (five surgeries so far) to remove it. It
keeps growing back. I am frustrated and emotionally weakened by the
repetitive surgeries. Is there an alternative?...

...First, some definitions. Idiopathic means "we don't know what
causes this." Subglottic refers to that part of the airway that is
immediately below the vocal cords. Essentially, the subglottis is the
gateway to the trachea (windpipe). Stenosis refers to circumferential
narrowing, usually due to scar tissue...

...This condition is problematic because concentric narrowing of the
airway is tantamount to slow suffocation. Something must be done to
restore the airway to its normal caliber, but what is the best
technique? Laser surgery with or without dilation ("stretching") is
certainly the most common approach. It is relatively simple and
painless, but has the disadvantage that the results may be temporary
-- as in your case.

One can also open the subglottis surgically and sew in grafts of
cartilage and mucosa; this procedure is known as laryngotracheal
reconstruction. This operation may provide you with lasting relief --
perhaps even permanent relief -- but it is not without risk. As part
of this procedure, you would probably also have to have a
tracheostomy, an operation in which a passageway is created between
the trachea and the skin of the lower neck. You would have to wear a
plastic tube in this passageway to hold it open. While the
laryngotracheal reconstruction heals, you would (in most cases) be
dependent on this tube for an airway. Once the reconstruction has
healed, the tracheostomy tube would usually be removed. The passageway
would heal in a matter of days.
 
by Douglas Hoffman"


The San Diego Center for Voice and Swallowing Disorders talks about
these type of procedures and notes:
http://www.sandiegovoice.org/stenosis%20and%20tracheotomy.html

"...Our approach to the patient with airway stenosis is to start with
the least invasive procedure and progress in a stepwise fashion as
dictated by the individual's response to treatment. All patients are
tested and treated for acid reflux if warranted. In our experience,
reflux control is critical for a successful surgical outcome.

The majority of stenoses can be treated endoscopically with the CO2
laser. Topical Mitomycin C is used on almost all patients. The
procedure usually takes less than 10 minutes to perform and patients
usually go home the same morning that their procedure was performed.
Several endoscopic procedures may be necessary. For more severe
stenoses a laryngotracheal reconstruction or, possibly, a
cricotracheal resection may be required. Although this procedure is
highly successful, the success of endoscopic control of the stenosis
restricts its frequent utilization.

The last resort for patients with airway stenosis is tracheotomy. If
necessary, we view tracheotomy as a temporary procedure until a
definitive surgery can be performed. Very few individuals with airway
stenosis require permanent tracheotomy."



Although there is a wealth of information on the Internet on
tracheotomies and alternatives, all are very similar in their use of
laser treatment, stents and finally tracheotomies where no other
alternative will work.

The Internet is also ripe with information on "alternative medicine"
treatments for all sorts of ailments and disorders, however none seem
to address tracheal scarring and it appears there is no homeopathic
remedy that could assist in this case.


You might be interested in reading this firsthand experience with
tracheotomies:

A Young Man's Voice (Experience with a Tracheotomy)
http://www.fsma.org/trach_02.shtml

and AdvanceRX has a pretty good background and description of
tracheotomies:
http://www.buildingbetterhealth.com/topic/topic100587585

Do consult your physician and ask about the treatments mentioned
above. And best of luck with a speedy recovery for your friend.


Search Strategy:

tracheotomy +alternative +scar -sleep
remove +trachea +scar
trachea +scar +"alternative medicine"
trachea +scar +homeopathic


I trust my research has been helpful and informative. If a link above
should fail to work or anything require further explanation or
research, please do post a Request for Clarification prior to rating
the answer and closing the question and I will be pleased to assist
further.

Regards,

-=clouseau=-
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