Tracheotomy is a surgical procedure in which an opening is made in the windpipe and a tube is inserted in it to assist in breathing. This article provides more information about this surgical procedure.
Tracheotomy is a surgical procedure wherein an opening is created in the trachea, or the windpipe. A tube is inserted in this opening and it is connected to the wind pipe to assist with breathing. This surgery is performed to bypass any obstruction in the upper airway, to deliver oxygen to the lungs, or to clean and remove secretion from the airway. The tube is removed when the person is able to breathe on his own or the passage is cleared. The opening closes on its own within a couple or weeks, leaving a scar. The first procedure was performed in 1852. Pierre Bretonneau, a French physician, performed it on a four-year old girl, whose air passage had become blocked due to the scar tissue of diphtheria forming there.
Reasons
As aforementioned, this procedure is usually performed to bypass the obstructed upper airway, to cleanse secretions in the airway, or to enable easy delivery of oxygen to the lungs.
Some of the conditions where this procedure is required are:
- If an object blocks the airway
- Cancer of the throat or neck, resulting in obstruction of breathing
- Severe injury to the mouth or neck
- If harmful steam or smoke is inhaled
- Swallowing is affected due to muscular paralysis
- Unconscious or comatose condition for a long period of time
Procedure
Generally, the procedure is performed in the operating room or in the intensive care unit. However, in case of an emergency, the procedure can be performed at the site of the accident. First, local anesthesia or an intravenous medication is given to make the procedure less painful. Then an incision is made in the lower part of the neck and the trachea is located, then an opening is made in the trachea. After this, a tube is inserted just below the larynx, or the voice box. More advanced techniques have also been devised, where a percutaneous approach is taken. It requires only a minute opening instead of an open incision, and hence is a less invasive procedure.
Recovery Period
The recovery time is generally 1-3 days, in which the patients usually learn how to breathe through the tracheotomy tube. Learning how to communicate with others takes a longer time. In the beginning, the patient may find it difficult to talk; however, with practice, the patient learns how to talk with a tube. During their stay at the hospital, the patients, or if it is a child, the parents, learn how to take care of the tracheotomy tube.
Certain medical institutions even provide home-care service. Patients can resume most of their daily activities, and they are encouraged to lead a normal life. While going out, it is recommended that they cover the hole or the stoma with a loose scarf or any other protective gear. Patients are also instructed about the safety precautions they need to follow regarding exposure to food particles, water, powder, aerosols, and so on.
Prognosis
In case the procedure has been performed as a temporary measure, then the tube is removed shortly after the person is able to breathe on his own. The opening heals quickly, with hardly any scarring. In case the tracheotomy tube has been inserted as a permanent measure, then the opening is not closed.
