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A tracheotomy is a surgical procedure performed to make an opening in the trachea, called a tracheostomy. Performed under general anesthesia, a tracheotomy involves positioning a tube through a tracheostomy, or artificial opening in the throat, in an effort to restore airflow to the lungs. Depending on the circumstances under which a tracheotomy is performed, the resulting tracheostomy may be temporary or permanent.
Although the terms tracheotomy and tracheostomy are often used interchangeably, there is a difference. Some medical dictionaries define tracheostomy as the actual surgical process to form an opening in the trachea, while also saying that the term is used for the opening itself. The Mayo Clinic and some other medical organizations also define tracheostomy as the artificial hole created during a surgical procedure called a tracheotomy.
Depending on the situation, a tracheotomy may be performed with either a local or general anesthetic. After the targeted area of the throat is sanitized, a scalpel is used to create a hole, called a stoma, through which a tracheostomy tube, also known as a trach tube, is positioned. Sutures may be taken to tighten up the area surrounding the stoma after the trach tube is in place. The newly positioned trach tube is usually further secured with a supportive device that is worn around the neck, such as a material or elastic band. As with any invasive procedure, there are some risks associated with tracheotomy and tracheostomy.
Among the most common risks are infection and excessive bleeding. Since a portion of the thyroid gland may be affected during tracheostomy placement, there is some risk of thyroid damage. Though rare, some individuals may experience tracheal erosion, which occurs when the outermost layer of skin at the incision site breaks down. In some cases, lung perforation or deflation can occur after a trach tube is introduced. Scar tissue may also form in the affected area, making breathing difficult.
Individuals whose airways become obstructed or are otherwise unable to breathe on their own may undergo a tracheotomy. In some instances, congenital conditions affecting tracheal development may necessitate a tracheotomy and tracheostomy placement. Most commonly, a tracheotomy and tracheostomy placement is performed in the wake of an injury to the larynx or trachea that leads to a significant obstruction of one’s airways. Other conditions that may require a tracheotomy and tracheostomy placement include tracheal swelling, paralysis of the throat and neck cancer.
Generally, a tracheostomy is only used over the short term. Individuals who undergo tracheotomy and tracheostomy placement must be educated about new approaches to common tasks, such as eating and speaking. Commonly under the guidance of a speech therapist, individuals are educated about how to communicate and exercise the muscles necessary for speaking and swallowing with a tracheostomy tube.
Once a trach tube is removed, the hole generally heals independently. If the trach tube is left in position for the long term, there is some risk of tracheal narrowing and displacement. Individuals with a tracheostomy must take precautions to ensure the trach tube does not become obstructed by foreign material, such as dirt, food or bodily fluids, like mucus. At the first sign of infection, discomfort or irritation in or around the stoma, individuals should contact their physician so complications may be avoided.