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. It 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.
In an emergency, a cricothyroidotomy may be done. This type of airway should only be used temporarily. If the airway will be needed for more than 48 hours, a standard tracheotomy will be done.
A tracheotomy is used to create an open airway. It is done to restore normal breathing in the following situations:
If you are planning to have a tracheotomy, your doctor will review a list of possible complications, which may include:
Some factors that may increase the risk of complications include:
Your doctor will likely do the following:
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
General anesthesia will be used. You will be asleep. In emergency situations, local anesthesia may be used. It will numb the area.
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.
You will breathe through this tube as long as it is in place. Oxygen and machines to assist breathing will be provided, if needed.
You will not be able to speak when the tube is in place unless you put a finger or other covering over the tube. This is because all the air going in and out of the tube bypasses the vocal cords.
A chest x-ray may be needed.
About 15-30 minutes
Anesthesia prevents pain during the procedure. You may have some pain and soreness during recovery. Your doctor can prescribe pain medicine to help relieve this discomfort.
The length of stay will depend on the reason for the procedure. Most stays are 1-5 days.
Once a tracheostomy tube is in place, you will experience breathing and vocal changes. It usually takes three days to adjust to breathing through the tube. Speaking is often a larger adjustment. Initially, you may not be able to speak.
After you leave the hospital, contact your doctor if any of the following occurs:
RESOURCES:
American Lung Association
http://www.lungusa.org/
National Institutes of Health
http://www.nih.gov/
CANADIAN RESOURCES:
Canadian Journal of Surgery
http://www.cma.ca/
The Lung Association
http://www.lung.ca/
References:
Beers MH, Berkow R, et al. The Merck Manual of Diagnosis and Therapy. 18th ed. Merck & Co.; 2006.
Creighton University School of Medicine website. Available at: http://medicine.creighton.edu/. Accessed October 14, 2005.
Cummings CW, et al. Otolayrngology: Head and Neck Surgery. 4th ed. St. Louis: Mosby, 2005.
Marx J, et al. Rosen's Emergency Medicine.7th ed. St. Louis, MO: Mosby, Inc., 2009.
Medical encyclopedia: tracheostomy. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/002955.htm. Accessed October 14, 2005.
The PDR Family Guide Encyclopedia of Medical Care. New York, NY: Ballantine Books; 1998.
Last reviewed November 2009 by Rosalyn Carson-DeWitt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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