A tracheostomy surgery is performed in certain medical conditions that lead to a blockage or narrowing of the airway in a patient. As part of the procedure, a hole is made through the front of the neck into the windpipe (trachea) and a silicon tube is inserted to keep it open for breathing.
This procedure helps provide an air passage for breathing when the usual route is blocked or narrowed. This procedure is also performed when a patient requires long-term use of a ventilator machine to breathe. A surgeon may also call for tracheostomy in certain emergencies like a traumatic injury to the neck or face. “It is common in critically ill patients, especially those dealing with respiratory issues. Patients whose breathing access has been blocked because of tumours, scars or any other reason may also need the same procedure; but again, inserting, removing or keeping it depends upon the related cases and concerned doctors’ observation,” said Dr Navneet Sood, pulmonary consultant, Dharamshila Narayana Superspeciality Hospital.
What cases require tracheostomy?
According to Mayo Clinic:
*Medical conditions that make it necessary to use a breathing machine (ventilator) for an extended period, usually more than one or two weeks.
*Medical conditions that block or narrow airways, 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 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 your mouth and into your trachea.
“Here, the basic idea is to create a pathway for breathing which has been blocked by tumour etc. or other reasons like vocal cord paralysis but more often this is inserted in the patients who have been on ventilators usually for more than 14 to 15 days, as the pathway for ventilator from the mouth cannot be kept for a prolonged time. Conscious patients are seen needing this procedure comparatively less,” Dr Animesh Arya, senior consultant in respiratory medicine, Sri Balaji Action Medical Institute, told indianexpress.com.
The hole naturally heals or is surgically closed, while in some people it remains permanent.
“Once the treatment is over and its basic function is done, the tracheostomy is removed with another procedure as per the treatment process, or it remains there when due to some reasons (like tumours) the breathing pathway has been blocked permanently. The area of tracheotomy procedure is vast and diverse as well, it’s insertion can be done in other diseases or conditions as well, but it entirely depends upon the case in point,” added Dr Arya.
Complications, if any
Tracheostomy complications can be considered in 3-time frames: immediate, early, and late, as per Respiratory Care journal. “In the most recent prospective randomized tracheostomy trials, adverse events associated with tracheostomy were common, especially bleeding, but were not life-threatening. All clinicians who are credentialed to perform tracheostomy should be familiar with the proper methods of managing complications associated with a tracheostomy,” it stated.