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Published on Mar 04, 2022 and last reviewed on Feb 20, 2023   -  5 min read


Severe blocks and complications in the windpipe require surgical procedures like a tracheostomy. Read this article to know more.



Tracheostomy is a medical treatment procedure in which a surgical incision is made at the windpipe for relieving an obstruction that causes breathing difficulties. It is done mainly during emergency conditions. The procedure can be done either temporarily or permanently in certain patients who are suffering from chronic illnesses.

In this procedure, an opening is made in the anterior portion of the neck known as the cricoid cartilage as a viable route for the entry of a tube into the affected person's trachea. The tube that is inserted is known as an endotracheal tube. This enables the passage of air to enter the lungs artificially. Air passes through this tube, bypassing the mouth, nose, and then the trachea. A tracheostomy procedure is usually called a stoma. This term is the particular name for the hole that is made at the neck through which the tube passes.

What Are the Conditions in Which Tracheostomy Is Required?

A tracheostomy is performed for many reasons. The main reason is to enable the passage of the air into the restricted airways. It might be done during emergency conditions when a person's airway is blocked suddenly. It could also be done in chronic disease conditions or any other problem that makes the regular breathing of the affected person so challenging to do it by their efforts.

The various clinical conditions which might require a tracheostomy procedure are:

What Are the Methods of Tracheostomy?

  • In many scheduled tracheostomy procedures, the patient will be put under general anesthesia. Due to the anesthesia, the patient will fall asleep throughout the procedure and will not feel any pain. In emergency conditions, the patient will be given local anesthesia at the anterior portion of the neck, and the procedure will be rushed and is done before the other scheduled procedures.

  • The local anesthesia would make the sensory nerves in the area of your neck so numb. The procedure will be started once the doctors ensure there is a total absence of pain once the anesthesia starts to work.

  • The surgeon will initially make an incision at the anterior portion of the neck exactly below the cricothyroid cartilage. The incision will pass through the cartilaginous rings that are significantly present at the trachea's surrounding wall. The hole is then opened into a wide hole that could afford the passage of a tracheostomy tube through it. After that, the surgeon hooks the patient to a mechanical ventilator, a machine that enables breathing artificially instead of the person's lungs. The tube will be secured strongly in place with a strong brown band that will stick around the person's neck.

  • These protective measures will keep the endotracheal tube in place without unnecessary movement so that the skin around the stoma heals adequately. In the case of conscious patients, there would be proper advice given regarding how to take care of the tracheostomy wound and the hygiene measures to protect infection through the endotracheal tube.

Do People Usually Adapt to Tracheostomy?

Almost all individuals who undergo this procedure will take a certain time to adapt mentally and physically to the tracheostomy tube. People will take a minimum of one to three days to adapt to the artificial breathing by a tracheostomy tube and being always fit to a mechanical ventilator. Talking consumes a lot of time and takes some practice. This is because the air the person breathes now does not pass through your larynx, making sound through phonation. Certain people talk by covering the tube. By recent advances, special valves could be attached along with the tracheostomy tube. This advancement enables the person to talk even while still in the air passing through the tube; these additional valves allow air to exit through the mouth and nose. As a result, speech is permitted.

What Are the Factors to Be Considered for Tracheostomy?

Every surgical procedure or accidental injury where the skin is opened increases the risk of infections as well as excessive bleeding. There are chances for the anesthesia to cause allergic reactions. It is usually very rare. However, it is seen more in emergencies where thorough history taking is not possible. In the case of conscious patients, it is always important for the patient or at least the relatives of the patient to inform their doctor if they had a previous history of allergic reaction to the administration of any anesthesia.

What Are the Risk Factors for Tracheostomy?

The following are the common risks that are associated with a patient who undergoes tracheostomy postoperatively.

  • The incision is made very near to the thyroid gland, so there is a risk of damage to the thyroid gland.

  • In very rare instances, there could be erosion at the trachea.

  • Any mistakes in the procedure, like the surgeon's slow operating speed, can lead to lung collapse.

  • The incision site at the trachea might produce permanent scar tissue.

Do They Require Home Care?

It is very important to provide adequate home care in patients who have a permanent tracheostomy. Cleaning the tube by using sterile solvents along with the skin around the stoma is needed to prevent infections at the incision site. The person who is going to clean must always wash their hands with antibacterial soap and water beforehand. It is essential to clean the skin around the stoma at least twice a day with a mix of distilled water and hydrogen peroxide. The suction catheters or other equipment used to remove aspirated fluid should also be cleaned very frequently.

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Frequently Asked Questions


Why Is a Tracheostomy Done?

The trachea or windpipe is responsible for the passage of air during breathing. When this windpipe is obstructed due to any severe head or neck injury or throat cancer, surgery is done where an opening is made in the windpipe externally to help the person breathe. This surgical procedure is called a tracheostomy.


Is Tracheostomy a Complicated Surgery?

Unfortunately, yes. Tracheostomy is a prevalent procedure done in emergencies. But, it has some severe complications.


Can a Person Talk After Having a Tracheostomy Surgery?

It is not impossible to talk with a tracheostomy. But, it will take at least two weeks to adjust and speak after the tracheostomy procedure. A speech therapist can help with this process.


What Is the Difference Between a Tracheostomy and a Ventilator?

Tracheostomy is a surgical procedure where an opening is made on the external surface of the trachea (windpipe) to help the person breathe. If necessary, an external oxygen supply can be connected to the tracheostomy to provide a supplemental oxygen supply (ventilator).


Who Needs Tracheostomy?

When a person has to be on a supplemental oxygen supply (ventilator) for more than two weeks, he needs a tracheostomy. The tracheostomy is done when the emergency personnel does not have access to the trachea to provide supplemental oxygen through the mouth.


Do COVID Patients Need Tracheostomy?

Not all COVID patients need a tracheostomy. When a person is severely ill after being infected by the coronavirus, and when a person needs a prolonged period of supplemental oxygen for support, then tracheostomy is done.


Is Tracheostomy Permanent?

In severe conditions like throat cancers or in situations where a person needs lifelong supplemental oxygen, needs to have a tracheostomy forever. However, mostly tracheostomy is allowed to close and heal on itself or can be surgically closed after the person recovers.


Can a Person Breathe on His Own With a Tracheostomy?

When there is an airway obstruction in the trachea (windpipe), a surgical procedure called tracheostomy is done where an external opening is made in the front of the throat to bypass the obstruction in the windpipe that helps the person breathe on their own.


How to Remove a Tracheostomy?

When a person no longer needs a tracheostomy, the tracheostomy is removed after thoroughly checking the patient’s condition. This process of removing the tracheostomy is called decannulation.
- The doctor makes the person lie on the bed or table supine.
- Then, the patient is given instructions that they may experience a feeling of breathlessness or might have breathing difficulties for a few minutes after removing the tracheostomy.
- The doctor also instructs the patient that they might experience mild discomfort while removing the tracheostomy from their windpipe.
- Then, the tracheostomy is removed carefully and slowly.
- The opening in the throat is then closed with gauze and is sealed with tape after the removal of the tracheostomy tube.
- The patient is advised to place their finger on the gauze whenever they sneeze or talk to cough to avoid air leakage through the opening.
- The opening is left to heal itself, which might take a few weeks.
In a few cases, tracheostomy is surgically removed, and the opening is closed surgically.


What Is the Difference Between an ET Tube and a Tracheostomy?

Both endotracheal tube (ET tube) and tracheostomy are examples of the artificial airway. The word ‘intubation’ means to insert a tube as an artificial airway. The term intubation is more commonly used when referring to the insertion of an ET tube.

Last reviewed at:
20 Feb 2023  -  5 min read




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