A tracheotomy is surgery to create an opening through the neck into the throat. The opening is called a stoma or tracheostomy. It may be temporary or permanent.
A tube called a tracheotomy tube will be inserted into the opening. Air may pass directly through this tube or tubing will be attached to a machine that helps with breathing.
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Reasons for Procedure
A tracheotomy is done to open a new pathway for air to move into the lungs. It may be needed in children who have damage or illness to the upper airways from things like:
- Smoke or chemical inhalation, or burns
- Nerve or muscle problems that affect the airway or breathing
- Weak chest and diaphragm muscles
- Narrowing of the airway just below the voice box
- Abnormal structures of the head, neck, or airway
- Foreign body obstruction
A tracheotomy may also be done if long-term mechanical ventilation is needed. It lets a child move, eat, drink, and speak while receiving ventilation. It can also lower the risk of breathing in foods and liquids.
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excessive bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Damage to nearby structures, such as vocal cords, nerves, or esophagus
- Lung injury
- Problems with swallowing, speaking, or eating
- An abnormal connection (fistula) to the esophagus or other structures
What to Expect
Problems to Look Out For
Call the doctor if your child is not getting better or has:
- Signs of infection, such as fever and chills
- Mucous that has a bad odor
- Redness, swelling, excessive bleeding, or any discharge from the incision site
- Pain that cannot be controlled with medicine
- Shortness of breath
- New or worsening symptoms
Call for emergency medical services right away if:
- The tracheostomy tube falls out and you cannot replace it
- Your child is having problems breathing through the tube
If you think your child has an emergency, call for medical help right away.
- Mechanical ventilation. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/mechanical-ventilation.
- Tracheostomy and ventilator dependence. American Speech-Language-Hearing Association website. Available at: https://www.asha.org/public/speech/disorders/tracheostomies-or-ventilators.
- Tracheostomy service. Johns Hopkins Medicine website. Available at: https://www.hopkinsmedicine.org/tracheostomy/about/index.html.
- Kari Kuenn, MD
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