Background: Suprastomal granulation tissue is a complication of tracheostomy which may
make decannulation difficult and presents a therapeutic challenge to the
Otorhinolaryngologists. The aims of this study therefore were to evaluate tracheostomy in black
African population, determine the prevalence of suprastomal granulation tissue and provide
updated information on it that will enable the otorhinolaryngologists to better understand and
manage the lesion.
Methods: We reviewed case files of patients who had tracheostomy between 1993 and 2007 at
University College Hospital, Ibadan, Nigeria for essential clinical data.
Results: Of the 256 patients who had tracheostomy, 133(51.95%) had prior orotracheal
intubation for 10 – 21days. Suprastomal granulation tissue complicated 16 (6.25%) cases, this
accounted for 88.89% of cases of failed decannulation. Indications for tracheostomy in these
patients included severe head injury in 12 (75%), tetanus in 3 (18.75%)] and intubation
granuloma in 1(6.25%) of these cases. Sixteen (4.3%) cases had stomal infection.
Conclusion: This study showed that the prevalence of suprastomal granulation is high among
our patients. There is a need for good surgical tracheostomy technique to prevent this
complication and stomal infection should be promptly treated while cuffed orotracheal
intubation for more than two weeks in unconscious and tetanus patients should be avoided.
