Tracheotomy: a life-saving surgery
Understanding the Procedure, Indications, and Management of Tracheostomy
What is Tracheostomy and When is it Performed?
Tracheostomy is a surgical procedure that involves creating an opening through the neck into the trachea, allowing for the insertion of a tube to facilitate breathing. The procedure is performed to bypass upper airway obstructions or manage severe respiratory issues. It is commonly used in cases of injuries, severe infections, vocal cord paralysis, throat tumors, or during major head or neck surgeries, as well as for patients requiring long-term mechanical ventilation.
How Tracheostomy is Performed
Tracheostomy can be performed as a surgical procedure or percutaneously. In surgical tracheostomy, a surgeon makes a horizontal incision at the lower part of the neck and then opens a hole in the trachea. In percutaneous tracheostomy, a less invasive approach is taken with a small incision, and an endoscopic camera is inserted through the mouth to visualize the trachea. In both cases, a tracheostomy tube is inserted to keep the incision open.
Management and Complications of Tracheostomy
After the procedure, the patient may need to stay in the hospital for several days for recovery. Post-operative management includes cleaning and caring for the tracheostomy tube and learning new ways of communication and swallowing. Some possible complications include bleeding, infections, damage to the esophagus or trachea, and the formation of fistulas. Good hygiene and proper tracheostomy tube care can reduce the risk of complications.
Long-Term Outlook and Decannulation
Tracheostomy can be temporary or permanent, depending on the patient’s needs. When it is no longer necessary, the tracheostomy tube can be removed, and the opening tends to close on its own. Decannulation, the removal of the tube, is performed when the patient is conscious, no longer requires the ventilator, and has adequate airflow to the lungs. After removal, there may be a temporary sense of breathing difficulty as one gets accustomed to breathing through the mouth and nose.
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