Why does Lyall need this surgery?

http://www.chop.edu/service/airway-disorders/open-airway-surgeries/single-stage-ltr.html#.UvVLv2zAQqM.facebook

A little bit of info about Lyalls operation. The above is a link showing a video of the actual operation.

Lyall will have had his tracheostomy for 4 years on 25th Feb. He originally needed it as he had a condition called broncho/tracheo malacia meaning his airways collapsed down making it impossible for him to breathe. He needed 24hr ventilation and therefore he had a tracheostomy to make this process easier and enable him to become established on a mobile ventilator. 

Lyall stopped being dependent on the ventilator in March 2012 and 2 attempts to decanulate (remove the trachy) followed but were unsuccessful. Further investigations showed he had developed a condition called suprastomal collapse meaning his upper airway was collapsing down making it impossible for him to breathe without the trachy. This was probably due to the fact he hadn't used his upper airway since having the trachy. He also has a smaller airway due to his down syndrome. There are also areas of scar tissue and there was lots of inflammation.Over the past 18months Lyall has been having regular reviews of his airway under General Anaesthetic with the ENT surgeon Mr Knight at the LGI. Throughout the course of this period the surgeon has removed granulation tissue, taken out his tonsils, done some work to make the epiglottis less floppy and generally monitored his airway to see if it was getting bigger.

 

At the last review on 6th Feb the surgeon said it was looking the best he has ever seen. Whilst he doesn't feel Lyall will cope if his tracheostomy were just removed he feels the time has come for him to do a full reconstruction of his airway which if successful would leave Lyall tracheostomy free. This surgery is taking place on 13th March. The operation will take up to 6hrs and then the recovery period is very hard. A piece of his rib will be removed and grafted into the 2 floppy areas in his airway to hopefully strengthen them. Lyall will be sedated and ventilated in Intensive Care for at least 5 days to allow the graft to heal. He will then return to theatre where he will be woken up and at that point they will know if it has been successful.

 

To say we are terrified is an understatement but we have to give Lyall this chance to be free of his tracheostomy. If it works it will be life changing for Lyall and for us and for him to go into school in September without his trachy will be fantastic.