Tracheostomy (tray-key-OS-tuh-me) is a hole that surgeons make through the front of the neck and into the windpipe (trachea). A tracheostomy tube is placed into the hole to keep it open for breathing. The term for the surgical procedure to create this opening is tracheotomy.
A tracheostomy provides an air passage to help you breathe when the usual route for breathing is somehow blocked or reduced. A tracheostomy is often needed when health problems require long-term use of a machine (ventilator) to help you breathe. In rare cases, an emergency tracheotomy is performed when the airway is suddenly blocked, such as after a traumatic injury to the face or neck.
When a tracheostomy is no longer needed, it's allowed to heal shut or is surgically closed. For some people, a tracheostomy is permanent.
A tracheostomy is a surgically created hole (stoma) in your windpipe (trachea) that provides an alternative airway for breathing. A tracheostomy tube is inserted through the hole and secured in place with a strap around your neck.
Situations that may call for a tracheostomy include:
Most tracheotomies are performed in a hospital setting. However, in the case of an emergency, it may be necessary to create a hole in a person's throat when outside of a hospital, such as at the scene of an accident.
Emergency tracheotomies are difficult to perform and have an increased risk of complications. A related and somewhat less risky procedure used in emergency care is a cricothyrotomy (kry-koe-thie-ROT-uh-me). This procedure creates a hole directly into the voice box (larynx) at a site immediately below the Adam's apple (thyroid cartilage).
Once a person is transferred to a hospital and stabilized, a cricothyrotomy is replaced by a tracheostomy if there's a need for long-term breathing assistance.
Tracheostomies are generally safe, but they do have risks. Some complications are particularly likely during or shortly after surgery. The risk of such problems greatly increases when the tracheotomy is performed as an emergency procedure.
Immediate complications include:
Long-term complications are more likely the longer a tracheostomy is in place. These problems include:
If you still need a tracheostomy after you've left the hospital, you'll need to keep regularly scheduled appointments for monitoring possible complications. You'll also receive instructions about when you should call your doctor about problems, such as:
How you prepare for a tracheostomy depends on the type of procedure you'll undergo. If you'll be receiving general anesthesia, your doctor may ask that you avoid eating and drinking for several hours before your procedure. You may also be asked to stop certain medications.
After the tracheostomy procedure, you'll likely stay in the hospital for several days as your body heals. If possible, plan ahead for your hospital stay by bringing:
A tracheotomy is most commonly performed in an operating room with general anesthesia, which makes you unaware of the surgical procedure. A local anesthetic to numb the neck and throat is used if the surgeon is worried about the airway being compromised from general anesthesia or if the procedure is being done in a hospital room rather than an operating room.
The type of procedure you undergo depends on why you need a tracheostomy and whether the procedure was planned. There are essentially two options:
For both procedures, the surgeon inserts a tracheostomy tube into the hole. A neck strap attached to the face plate of the tube keeps it from slipping out of the hole, and temporary sutures can be used to secure the faceplate to the skin of your neck.
You'll likely spend several days in the hospital as your body heals. During that time, you'll learn skills necessary for maintaining and coping with your tracheostomy:
In most cases, a tracheostomy is temporary, providing an alternative breathing route until other medical issues are resolved. If you need to remain connected to a ventilator indefinitely, the tracheostomy is often the best permanent solution.
Your health care team will help you determine when it's appropriate to remove the tracheostomy tube. The hole may close and heal on its own, or it can be closed surgically.