Anyone who is having difficulty breathing is a little scared when they say they are going to make a hole in the neck and put a tube through it, right? In medicine, we call this a tracheostomy . But this is a very important treatment that is done to save lives, and is often temporary. Even if you have heard about this, you may have big questions and fears because you don't know exactly what it is. So let's talk about it all clearly and simply today.
What exactly is a tracheostomy?
Simply put, a tracheostomy is a surgical procedure that creates an opening, or hole, in the front of your neck, directly into your windpipe (bronchi) . A tracheostomy tube is then inserted through this opening into your windpipe. This essentially allows someone who has difficulty breathing through their mouth and nose to breathe air (oxygen) directly into their lungs through this tube in their neck, bypassing those two routes.
We also call the surgery to create this hole a tracheotomy . However, in common parlance, even doctors use both words interchangeably.
When is a tracheostomy necessary?
There are many reasons why a tracheostomy may be performed. Although this is often a planned surgery, it is sometimes necessary in emergencies. The table below will give you a good idea of this.
| Reason for needing treatment | Simply explained |
|---|---|
| Airway obstruction | If the airway is blocked due to a throat tumor, severe infection, or accident and intubation is not possible. |
| Long-term breathing difficulties | If you cannot breathe on your own due to conditions such as severe lung disease, paralysis, or serious head or neck injuries. |
| Being connected to a ventilator | If someone needs to be connected to a ventilator for more than a week, this method is easier and safer. |
| Difficulty clearing mucus | Due to some medical conditions, coughing cannot clear mucus from the lungs. Suctioning the mucus through this tube is very easy. |
| After throat surgery | After surgery on the throat or voice box, as an aid to breathing until the area heals. |
The important thing is that, depending on your condition, this tracheostomy can be temporary or permanent . Your doctor will explain this to you in detail.
How should I prepare before this surgery?
If this is a planned surgery, your doctor will tell you how to prepare for it. Since it is usually performed under general anesthesia , you may be asked to avoid eating or drinking for a few hours before the procedure and to stop taking certain medications.
Since you will be in the hospital for a few days or weeks after the surgery, you need to pack a small bag.
- Clothing and personal items: Comfortable bed clothes, things like a toothbrush.
- Medications you are taking: Bring any medications and vitamins you are currently taking.
- Something to entertain yourself: Carrying something like a book or magazine can be a comforting experience during your recovery.
- Communication equipment: This is very important. You may find it difficult to talk for a few days after surgery. So, bringing a notebook and pen, or your smartphone or tablet, will be a great help in communicating with the doctors, nurses, and family.
How is the surgery performed?
There are two main methods.
1. Open Surgery (Open Tracheotomy)
This is the traditional method. It is done in an operating room. You are put to sleep and then you are put under general anesthesia. The surgeon then makes a small incision in your neck, just below your Adam's apple. The incision exposes your windpipe ( bronchi ) and creates a small opening in it. The tracheostomy tube is then inserted through the opening and secured with a tracheostomy collar. If you are unable to breathe on your own, this tube is connected to a ventilator.
2. Percutaneous Tracheostomy
This is a new method. It can often be done in the hospital bed. There is no large incision. Instead, a needle is used to make a hole in the neck and trachea. Then, the hole is gradually enlarged and the tube is inserted. This causes less damage to the tissue.
What are the benefits and potential risks?
The main advantage is that it provides the air needed to survive to someone who cannot breathe through their nose and mouth. It is also much more comfortable for the patient than having a tube in their mouth for a long time. It is also a great help for those who are starting to breathe on their own after being weaned off a ventilator.
However, like any surgery, there are some risks.
| Possible Complication |
|---|
| • Bleeding and infection. |
| • Damage to the esophagus or trachea. |
| • Narrowing of the airway due to scar tissue. |
| • Damage to the nerve that controls the vocal cords (recurrent laryngeal nerve) . |
| • Tracheostomy tube blockage due to mucus or blood clots. |
| • Air trapped in the lungs, chest, or under the skin. |
Many of these risks can be reduced by following medical instructions exactly and keeping the tube clean.
How is life after surgery?
The medical team will closely monitor your recovery after the surgery. It can take up to two weeks for the incision to fully heal. It is normal to feel some neck pain during this time. It will take a day or two to get used to breathing through the tube.
Talking
After some time to heal, you will be able to speak with practice. The sound is made by covering the hole in the tube with your finger and blowing air through your mouth. A speech-language pathologist (SLP) can help you with this. There are also special types of speaking valves that help you speak without covering your finger.
Eating
It will take some time to get used to swallowing. In the beginning, you may be fed through a tube or a tube. Your speech therapist can also help you eat normally through swallowing exercises.
Removing the tube
If your tracheostomy is temporary, your doctor will remove the tube once your airway is normal. This is called decannulation . Sometimes the hole will close on its own, or you may need to have a minor surgery to close it. You may be left with a small scar.
| If you have these symptoms, inform your doctor or hospital immediately! |
|---|
| - If you experience any difficulty breathing. |
| - If you feel your heartbeat is irregular. |
| - If you have severe pain that does not subside even after taking medication. |
| - If there is swelling, adhesions, or signs of infection (fever, redness, pus) around the tube. |
| - If the tracheostomy tube becomes dislodged or completely dislodged. This is an emergency. Go to the nearest Emergency Department (ETU) immediately. |
It's normal to feel scared and uncertain when you're told you need a tracheostomy. But remember, with the help of your medical team, many people can learn to breathe, eat, drink, and talk normally with this procedure. Whether it's temporary or permanent, don't let it stop you from doing the things you love and living a happy life. Talk openly with your doctor about any concerns or fears you may have.
Take-Home Message
- A tracheostomy is a surgical opening made into the windpipe in the neck to aid breathing.
- This is done for serious reasons such as airway obstruction and being connected to a ventilator for a long time.
- For most people, this is temporary, and the tube is removed after healing.
- Proper cleaning and care of the tube at home is essential to avoid complications.
- With the help of a speech therapist and medical team, you can get back to talking and eating.
- It is very important to seek medical advice immediately in case of difficulty breathing, signs of infection, or a tube dislodgement.
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