A tracheotomy is a surgical procedure used to make an opening in the windpipe (trachea) to remove an obstruction or allow air to pass through to the lungs. An incision is made below the vocal cords, and a plastic or metal tube is inserted to keep the incision open. The tube is usually connected to a ventilator machine that helps with breathing, although, depending on the patient's condition, a ventilator may not be needed. A tracheotomy is usually performed to alleviate breathing problems, and is often performed in emergency situations after more conservative methods have failed.

Reasons for a Tracheotomy

A tracheotomy may be performed anytime there is the possibility that a patient is or will be unable to breathe. Its applications include the following:

  • Bypassing an obstruction in the airway
  • Providing long-term breathing support
  • Providing a temporary airway during a procedure that might restrict breathing
  • Providing a temporary airway in an emergency situation in which breathing is obstructed

After a tracheotomy, the inserted tube can remain in place as long as breathing support is needed. In some cases, it remains in place permanently.

Types of Tracheotomy Procedures

An emergency tracheotomy is a quick procedure that involves a cut in the larynx, and the insertion of a tube to provide oxygen to the patient. A nonemergency tracheotomy is more thorough; it involves cutting into the neck, and separating the neck muscles before cutting into the trachea. An oxygen tube is then inserted to let the patient breathe and help remove the obstruction. Depending on how long the tube is needed, the opening in the neck is closed up surgically or with stitches.

Complications of a Tracheotomy

Although a tracheotomy is considered safe, the following complications are possible:

  • Bleeding
  • Infection
  • Damage to the thyroid gland
  • Nerve injury

In some cases, there may be scarring on the skin of the neck where the tube was inserted, and to the trachea itself.

Recovery from a Tracheotomy

It may take several days to adjust to breathing through the tracheotomy tube; difficulty breathing and speaking with the tube in place is common. Eating can also be difficult, and a patient may be fed intravenously while healing from a tracheotomy. Recovery can take a few weeks, and require speech therapy to help regain the muscle strength and coordination needed for speaking and swallowing.

After training and practice, a patient can usually function well with a tracheotomy tube in place.

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