Tracheotomy
A tracheotomy is a surgical procedure that helps a person breathe by making 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 may be connected to a ventilator that helps with breathing, although, depending on the patient's condition, a ventilator may not be needed. A tracheotomy is often performed in emergency situations after more conservative methods to help a person breathe have failed.
Reasons for Tracheotomy
Applications for tracheotomy 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 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
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 with stitches or tape.
Complications of Tracheotomy
Although 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 Tracheotomy
It may take several days to adjust to a 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 takes a few weeks, and may include 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.