Tracheotomy—Adult

(Tracheostomy)

Definition

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.
Tracheostomy
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Reasons for Procedure

A tracheotomy 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.A tracheotomy is done to restore normal breathing in the following situations:
  • The airway is obstructed at or above the level of the larynx, which is also known as the voice box, due to:
    • Trauma to the neck area
    • Obstructing tumors in the upper airway
    • Vocal cord paralysis
    • Removal of larynx for throat cancer
  • Respiratory failure requiring long-term mechanical breathing assistance, as in these cases:
    • Spinal cord injury in the neck area
    • Severe lung infection or inflammation
  • If you have been on a ventilator for 21 days
  • Injury to the respiratory tract due to breathing in smoke or steam or inhaling corrosive substances
  • Birth defects of the trachea or larynx
  • Foreign object blocking the trachea or larynx
  • Severe sleep apnea

Possible Complications

If you are planning to have a tracheotomy, your doctor will review a list of possible complications, which may include:
  • Bleeding
  • Infection
  • Damage to the vocal cords, vocal cord nerves, or esophagus
  • Damage to the lungs
  • Difficulty swallowing
  • Air trapped in tissue under the skin of the neck
  • Low blood pressure
  • Tracheostomy tube displacement or damage
  • Scarring at the site of operation leading to closure of the tracheostomy or tracheal narrowing
  • Abnormal connection to esophagus or surrounding blood vessels
Some factors that may increase the risk of complications include:
  • Age: infants and elderly adults
  • Obesity
  • Smoking
  • Poor nutrition
  • Recent illness, especially an upper-respiratory infection
  • Alcoholism
  • Long-term illnesses
  • Use of certain prescription and nonprescription drugs

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