Tracheostomy

A tracheostomy (tray-key-OS-tuh-me) is a hole that surgeons make through the front of the neck and into the windpipe, also known as the trachea. Surgeons place a tracheostomy tube into the hole to keep it open for breathing. The term for the surgical procedure to create this opening is tracheotomy.

A tracheostomy may be needed when: Medical conditions make the use of a breathing machine, also known as a ventilator, necessary for an extended period, usually more than one or two weeks. Medical conditions, such as vocal cord paralysis, throat cancer or mouth cancer, block or narrow the airway. Paralysis, conditions that affect the brain and nerves, or other conditions make it hard to cough up mucus from your throat and make direct suctioning of the windpipe, also known as your trachea, necessary to clear your airway. Major head or neck surgery is planned. A tracheostomy helps with breathing during recovery. Severe injury to the head or neck blocks the usual way of breathing. Other emergency situations occur that block your ability to breathe and emergency personnel can't put a breathing tube through your mouth and into your windpipe.

Tracheostomies are generally safe, but they have risks. Some complications are more likely during or shortly after surgery. The risk of complications is greater when a tracheotomy is done as an emergency procedure. Complications that can occur right away include: Bleeding. Damage to the windpipe, thyroid gland or nerves in the neck. Movement of the tracheostomy tube or placement of the tube that isn't correct. The trapping of air in tissue under the skin of the neck. This is known as a subcutaneous emphysema. This issue can cause breathing problems and damage to the windpipe or the food pipe, also known as the esophagus. Buildup of air between the chest wall and lungs that causes pain, breathing problems or lung collapse. This is known as pneumothorax. A collection of blood, also known as a hematoma, that may form in the neck and squeeze the windpipe, causing breathing problems. Long-term complications are more likely the longer a tracheostomy is in place. These problems include: Blockage of the tracheostomy tube. Movement of the tracheostomy tube from the windpipe. Damage, scarring or narrowing of the windpipe. Development of an unusual passage between the windpipe and the esophagus. This makes it more likely that fluids or food could enter the lungs. Development of a passage between the windpipe and the large artery that supplies blood to the right arm and right side of the head and neck. This can result in life-threatening bleeding. Infection around the tracheostomy or infection in the windpipe and bronchial tubes or lungs. An infection in the windpipe and bronchial tubes is known as tracheobronchitis. An infection in the lungs is known as pneumonia. If you still need a tracheostomy after you've left the hospital, you'll likely need to keep regularly scheduled appointments to watch for possible complications. You'll also likely get instructions about when you should call your healthcare professional about problems, such as: Bleeding at the tracheostomy site or from the windpipe. Having a hard time breathing through the tube. Pain or a change in comfort level. A change in skin color or swelling around the tracheostomy. A change in the position of the tracheostomy tube.

How you prepare for a tracheostomy depends on the type of procedure you'll have. If you'll be having general anesthesia, your healthcare professional may ask that you not eat or drink for several hours before your procedure. You also may be asked to stop taking certain medicines.