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Why it's done
By Mayo Clinic staffSituations that may call for a tracheostomy include:
- Medical conditions that require the use of a breathing machine (ventilator) for an extended period, usually more than one or two weeks
- Medical conditions that block or narrow your airway, such as vocal cord paralysis or throat cancer
- Paralysis, neurological problems or other conditions that make it difficult to cough up secretions from your throat and require direct suctioning of the windpipe (trachea) to clear your airway
- Preparation for major head or neck surgery to assist breathing during recovery
- Severe trauma to the head or neck that obstructs breathing
- Other emergency situations when breathing is obstructed and emergency personnel can't put a breathing tube through the mouth and into the trachea
Emergency care
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 cricothyroidotomy. 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 cricothyroidostomy is replaced by a tracheostomy if there's a need for long-term breathing assistance.
- Tracheostomy. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/trach/trach_all.html. Accessed Sept. 22, 2010.
- Weissler M, et al. Tracheotomy and intubation. In: Bailey B, et al., eds. Head & Neck Surgery — Otolaryngology. 4th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2006. http://ovidsp.tx.ovid.com/sp-3.2.2b/ovidweb.cgi. Accessed Sept. 21, 2010.
- Maragos NE (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 13, 2010.
- Custalow CB. Emergent surgical cricothyroidotomy (cricothyrotomy). http://www.uptodate.com/home/index.html. Accessed Sept. 21, 2010.
- Speech for people with tracheostomies or ventilators. American Speech-Language-Hearing Association. http://www.asha.org/public/speech/disorders/tracheostomies.htm. Accessed Sept. 11, 2010.
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