Tracheostomy: Treatment, Procedure, Cost and Side Effects

Tracheostomy is a medical procedure that consists of making an incision on the anterior part of the neck and placing a tube into the person’s windpipe or the trachea. The tube is inserted through a cut in the neck below the vocal cords that allows air to enter the lungs. Breathing is then done through the tracheal tube or the tracheostomy tube, bypassing the mouth, nose and throat.

There are various reasons for performing tracheostomy. It is done when the normal passing of air into the lungs is blocked. Conditions that arise the need for tracheostomy are anaphylaxis, birth defects of the airway, burns of the trachea or the airway from inhalation of carcinogenic items, throat cancer, chronic lung disease, diaphragm malfunctioning, facial burns, infection of the trachea, injury of the larynx, injury in the chest wall, need for prolonged respiratory support due to breathing trouble, obstruction of the trachea due to presence of an alien object, obstructive sleep apnea, paralysis of the muscles involved in swallowing food, severe mouth and neck injuries, tumours in the trachea and vocal cord paralysis.

A tracheostomy tube consists of an outer cannula or a main shaft, and inner cannula and an obturator. The obturator is used when the tracheostomy tube is inserted so as to guide the placement of the outer cannula, and is removed after the outer cannula is placed properly. Since secretions build up in the outer cannula, an inner cannula is also placed when the former is removed for cleaning. These tubes may have cuffs or inflatable balloons at the end of the tube to secure it in the proper place. A tracheostomy tube can have holes along its body, to let air pass through the larynx that will in turn allow the person to speak.

Tracheostomy is the surgical procedure accompanied by the creation of a hole or opening by an incision through the trachea in front of the neck. It is a common surgery that is usually done to treat the abnormalities related to breathing. But Tracheostomy is considered a major surgery too since it involves invasion of the cells or tissues of the body. This surgical procedure has its own risks as well as moderate to severe complications. Hence, it should be considered a serious surgery.

Summary: Tracheostomy is a major surgery that is done to treat the abnormalities related to breathing. It involves invasion of tissues or cells and hence it has some risks and complications. It should be done under the supervision of a specialist.

At the beginning of this surgical treatment, anesthesia is used, so that the patient falls asleep and do not feel the pain. Local anesthasia is provided in the time of emergencies in order to keep that place numb. It is to be kept in mind that the neck should be kept clean before the surgery begins.

After the anesthesia starts working, the surgery begins. The patient is laid on his/her back on the table with a cushion placed under the shoulders to keep the head in an inclined position. The trachea is opened by the surgeon with the help of a sharp pointed needle. The cut is made just below the Adam’s Apple and the top of the breastbone. The cut goes through the cartilage ring of the outer wall of the trachea. The hole is then cut by clamping the isthmus thyroid gland with the help of the haemostatic forceps wide enough to place the tube. Haemostatic forceps are used to control the bleeding once the throat is cut open. A metal or plastic tube, which is supposed to work as a trachea is placed into the cut made in the throat. This tube is known as the tracheostomy tube. It acts like the real trachea allowing the person to breathe. A mechanical ventilator may be attached to the tube to bring oxygen to the lungs. A dressing is done on the outer portion of the opening made in the throat. Tape or stiches are used to keep the tube in the proper place.

At last, the neck and chest area are disinfected and surgical drapes are placed over the area that sets up a sterile surgical field.

A person who is unable to breathe normally through his or her existing windpipe is asked to take this surgery. Tracheostomy can be performed by any person who cannot breathe normally, due to malfunctioning of the parts of the respiratory system, especially the windpipe or the lungs. Also people with injuries who cannot breathe normally are asked to perform this surgery.

People who do not have any abnormality in their respiratory systems, or the people who can breathe properly without any kind of serious breathing problems do not need this surgical treatment.

Tracheostomy is a major surgery that is performed under general anesthesia. The procedure is accompanied by making an opening in the front portion of the neck, followed by inserting a pipe in the windpipe to facilitate breathing. It usually takes a few days or even a few weeks for a patient to recover completely after undergoing a Tracheostomy. It takes that much time for the inserted tube to be removed from the throat, followed by closing the opening completely.

Summary: Tracheostomy is a major surgery involving major tissues or cell invasion. Hence, it requires proper care and attention for the wound to get healed completely. A few days to a few weeks are essential for complete recovery post-surgery.

Severe bleeding is one of the most common immediate side effects of tracheostomy. Also, the tube that has been inserted can be blocked with blood clots, mucus, or pressure of the airway walls.

Long term side effects can also occur after tracheostomy is performed. The windpipe (into which the tube is inserted) can be permanently damaged due to bacterial deposition leading to infection, or high air pressure on the side of the walls of the tracheostomy tube. Sometimes the opening doesn’t close on its own after the tube is removed. Such conditions can create problems within the throat.

The thyroid glands can get damaged during this treatment. Lung puncture or lung collapse can also occur. Even death can also occur due to tracheostomy, but the percentage is less than 5%.

Since tracheostomy is a complicated surgery, people who undergo this surgery have to follow certain guidelines. The most important rule that is to be followed is getting used to breathe through the new tube that has been inserted into the throat. It takes one to three days for a person to get adapted to the tracheostomy tube. Talking and making sounds as well as breathing through this tube take time and practice. This is because the air that is breathed in does not pass through the voice box anymore. For some people covering the tube helps to talk.

Also, special valves can be attached to the tracheostomy tube. These valves allow air to enter and exit the mouth and nose while the person is talking and hence allows the person to speak without any obstacles.

After the treatment of tracheostomy is performed, the patient has to stay in the hospital for a maximum of 5 days and it takes about two weeks to recover fully. After the cut made into the throat is healed, the person has to stay careful in order to avoid any infections. Any kind of damage to the tube can affect the other organs located near it. So the person who has undergone this surgery needs to be very careful about this.

The price of the surgical treatment of tracheostomy in India ranges between Rs. 33,80,000 to Rs.65,00,000.

Tracheostomy is a surgery that has permanent results on the on the patient once the tube is fit in. The tube should be handled by the patients themselves. The doctors should inform the affected persons regarding the maintenance and cleaning of the tube.

Biphasic cuirass ventilation is non-invasive mechanical ventilation that can allow the patients an alternative mode of respiratory support. This does not involve cutting of the throat which can further lead to various complications.

Conclusion: Tracheostomy is a major surgery that is performed under general anesthesia. The procedure is accompanied by making an opening in the front portion of the neck, followed by inserting a pipe in the windpipe to facilitate breathing. It is important as usually done to treat the abnormalities related to breathing.