Tracheostomy

1 What is a Tracheostomy?

A tracheostomy is a surgical procedure during which an opening is created in the neck that leads directly to the trachea (the breathing tube) and it is maintained open with a hollow tube called a tracheostomy tube.

It is done to easily and safely deliver oxygen to the lungs and to clean and remove secretions from the airway. Usually, a tracheostomy is done in patients who are seriously ill and have multiple organ-system problems.

The procedure can be performed in the operating room or in the intensive care unit under local anesthesia and patient monitored by pulse oximeter (oxygen saturation) and cardiac rhythm (EKG).

During the procedure, the surgeon will make an incision low in the neck and an opening in the trachea below the voice box (larynx) for the new breathing passage. The tube inserted during first procedure must be changed after 10 to 14 days.

With new techniques, this procedure is performed via a percutaneous approach (a less invasive approach using a piercing method rather than an open surgical incision).

The patient will have difficulty speaking and with oral feeding until the size of the tube is decreased. If the tube is necessary for a long period of time, the patient and family will learn how to suction of the trachea, and change and clean the tube, but often a home health care is provided or the patient is transferred to an intermediate health care facility.

The risks and complications of tracheostomy which can occur are:

  • Infection
  • Bleeding
  • Air trapping in the surrounding tissues or chest
  • Impaired swallowing and vocal function
  • Scarring of the neck

Rare complications which can occur are:

  • Damage to the larynx or airway with resultant permanent change in voice
  • Scarring of the airway or erosion of the tube into the surrounding structures
  • Airway obstruction
  • Aspiration of secretions
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