Tracheostomy

Tracheostomy (sometimes called tracheotomy) is the creation of an opening directly into the trachea (windpipe) in the neck for the purpose of assisting breathing. While tracheotomy used to be done as an emergency, it is now done more on an elective basis to protect the airway, better clean the airway and to provide more oxygen to the lungs.

Anatomy and Physiology

 

Figure 1 - The trachea as seen from in front. The trachea lies below the thyroid cartilage, which forms the front wall of the larynx. The thyroid isthmus crosses the trachea and the recurrent laryngeal nerve (to the vocal cords) lies on each side of the trachea. © T. Graves Figure 2 - Section through the neck showing the relationships of the trachea to the larynx, esophagus and thyroid isthmus. © T. Graves

Pathology

Indications for surgery

Surgical Procedure

Figure 3 - The patient is placed with the head and neck extended. © T. Graves Figure 4 - The procedure can be carried out using either a vertical (up and down) or horizontal (side to side) incision. © T. Graves
 

 

Figure 5 - The trachea is exposed and an incision made in the second tracheal ring. © T. Graves Figure 6 - The tracheostomy tube is inserted into the trachea. © T. Graves
 

 

Figure 7 - The position of the tracheostomy tube in the trachea. Note that the balloon on the tube is inflated to prevent secretions from going into the lungs. © T. Graves Figure 8 - The wound is closed around the tracheostomy tube. © T. Graves

Complications

Care After Surgery

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