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Tracheotomy is the surgical creation of an opening from the outside of the neck into the windpipe. A tube is inserted into the opening to allow for normal breathing.
Reasons for Procedure
A tracheotomy is done to bypass obstructions that are interfering with breathing. The opening is called a stoma or tracheostomy. A stoma may be either temporary or permanent.
A tracheotomy is done to restore normal breathing in the following situations:
The airway is obstructed at or above the level of the larynx, which is also known as the voice box, due to:
- Trauma to the neck area
- Obstructing tumors in the upper airway
- Vocal cord paralysis
- Removal of larynx for throat cancer
Respiratory failure requiring long-term mechanical breathing assistance, as in these cases:
- Spinal cord injury in the neck area
- Severe lung infection or inflammation
- If you have been on a ventilator for 21 days
- Injury to the respiratory tract due to breathing in smoke or steam or inhaling corrosive substances
- Birth defects of the trachea or larynx
- Foreign object blocking the trachea or larynx
- Severe sleep apnea
If you are planning to have a tracheotomy, your doctor will review a list of possible complications, which may include:
- Damage to the vocal cords, vocal cord nerves, or esophagus
- Damage to the lungs
- Difficulty swallowing
- Air trapped in tissue under the skin of the neck
- Low blood pressure
- Tracheostomy tube displacement or damage
- Scarring at the site of operation leading to closure of the tracheostomy or tracheal narrowing
- Abnormal connection to esophagus or surrounding blood vessels
Some factors that may increase the risk of complications include:
What to Expect
Prior to Procedure
Your doctor will likely do the following:
- Chest x-ray
- Blood and urine tests
- Review of medications
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
General anesthesia will be used. You will be asleep. In emergency situations, local anesthesia may be used. It will numb the area.
Description of Procedure
A cut will be made in the skin of the neck. A section at the front of the windpipe will be removed. A tracheostomy tube, which will act as the airway, will then be fitted into this opening in the windpipe. The skin will be closed around the tube with stitches or clips.
Immediately After Procedure
You will breathe through this tube as long as it is in place. Oxygen and machines to assist breathing will be provided, if needed. A chest x-ray may be needed.
How Long Will It Take?
About 15-30 minutes
How Much Will It Hurt?
Anesthesia prevents pain during the procedure. You may have some pain and soreness during recovery. Your doctor can prescribe pain medication to help relieve this discomfort.