Is a Tracheostomy?
A tracheostomy is
a medical procedure — either temporary or permanent — that involves creating an
opening in the neck in order to place a tube into a person’s windpipe.
The tube is inserted through a cut in the neck below the vocal
cords. This allows air to enter the lungs. Breathing is then done through the
tube, bypassing the mouth, nose, and throat.
A tracheostomy is commonly referred to as a stoma. This is the name for the hole in
the neck that the tube passes through.
a Tracheostomy Is Performed
A tracheostomy is performed for several reasons, all involving
restricted airways. It may be done during an emergency when your airway is
blocked. Or it could be used when a disease or other problem makes normal
Conditions that may require a tracheostomy include:
- birth defects of the airway
- burns of the airway from inhalation of corrosive
- cancer in the neck
- chronic lung disease
- diaphragm dysfunction
- facial burns or surgery
- injury to the larynx or laryngectomy
- injury to the chest wall
- need for
prolonged respiratory or ventilator support
- obstruction of the airway by a foreign body
- paralysis of the muscles used in swallowing
- severe neck or mouth injuries
- vocal cord paralysis
to Prepare for a Tracheostomy
If your tracheostomy is planned, your doctor will tell you how to
prepare for the procedure. This may involve fasting for up to 12 hours before
If your tracheostomy is performed during an emergency, there will
be no time to prepare.
a Tracheostomy Is Performed
For most scheduled tracheostomies, you’ll be given general
anesthesia. This means you’ll fall asleep and won’t feel any pain. In
emergencies, you’ll be injected with local anesthesia. This numbs the area of
your neck where the hole is made. The procedure will begin only after the
anesthesia has started working.
Your surgeon will make a cut into your neck just below your
Adam’s apple. The cut will go through the cartilage rings of the outer wall of
your trachea, also known as your windpipe. The hole is then opened wide enough to
fit a tracheostomy tube inside.
Your doctor may hook up the tube to a ventilator, in case you
need a machine to breathe for you. The tube will be secured in place with a
band that goes around your neck. This helps keep the tube in place while the
skin around it heals. Your surgical team will tell you how to care for the
wound and your tracheostomy tube.
Adapting to a tracheostomy tube
It typically takes one to three days to adapt to breathing through
a tracheostomy tube. Talking and making sounds also takes some practice. This
is because the air you breathe no longer passes through your voice box. For
some people, covering the tube helps them talk.
Alternately, special valves can be attached to the tracheostomy
tube. While still taking in air through the tube, these valves allow air to
exit the mouth and nose, permitting speech.
Risks of a Tracheostomy
Every medical procedure where the skin is broken carries the risk
of infection and excessive bleeding. There’s also a chance of an allergic
reaction to anesthesia, although it’s rare. Tell your doctor if you’ve had an
allergic reaction to anesthesia in the past.
Risks specific to a tracheostomy include:
- damage to the thyroid gland in the neck
- erosion of the trachea, which is rare
- lung puncture and lung collapse
- scar tissue in the trachea
After a Tracheostomy
If your tracheostomy is temporary, there’s typically only a small
scar left when the tube is removed.
Those with a permanent tracheostomy may need assistance to get
used to the stoma. Your doctor will give you tips about cleaning and
maintaining the tube.
Though people with tracheostomies have initial difficulty
speaking, most can adjust and learn to speak.