Tracheotomy literally means hole inside the trachea or windpipe. Patients may require a tracheotomy for a number of reasons, including:
- Need to be on a ventilator for a prolonged period of time
- Upper Airway Obstruction including certain infections of the tongue and neck
- Bilateral vocal fold immobility
- Subglottic stenosis
- Tracheal stenosis
- Cancers of head, neck, mouth, tongue and laryn
A tracheotomy tube works by allowing a person to breathe through their neck instead of the mouth. Because of this patients with tracheotomy tubes cannot swim, as water will enter the airway.
Patients with a tracheotomy tube are able to speak and eat. An exception is patients who require the ventilator to breathe.
Tracheotomy is typically performed in the operating room, although it can be performed in the intensive care unit. A small amount of numbing medication is placed on a patient’s neck and a cut is made into the neck through the skin. The thyroid gland is often identified over the trachea and divided in the middle. The does not affect the function of the thyroid gland. The trachea is identified and a small hole is made in it. A tracheotomy tube is placed into the neck.
A tracheotomy is not necessarily a permanent procedure. There are times when a tracheotomy is no longer necessary. For example in case of an infection, once it is treated, a patient may again be able to breathe through the mouth.
A patient then goes through a capping trial in which case a patient breathes through the mouth. The tube is then removed and gauze is placed over the wound. The hole closes up on its own, usually over the course of a week.