What is a tracheotomy?

A tracheotomy is a surgical procedure in which a cut is made in the neck and a hole is created in the trachea (windpipe) to allow for a breathing tube to be inserted. The procedure may be performed if there is an obstruction in your upper airway or if you are not able to breathe on your own, such as after an injury to the head. The breathing tube, also called tracheostomy or trach tube, may also be needed if you have:

  • An inherited condition affecting the larynx or trachea
  • Cancer of the neck that affects swallowing or breathing
  • Muscle paralysis that affects swallowing
  • Laryngectomy (surgery around the larynx)
  • Have inhaled toxic material that causes airway to swell

The tracheostomy can also help facilitate removal of sputum (mucus), such as after laryngeal surgery.

Tracheostomy and tracheotomy are terms that are often used interchangeably though tracheotomy refers to the incision and procedure itself and tracheostomy commonly refers to the resulting hole and breathing apparatus. For some patients, tracheostomy is a temporary need during recovery from illness, injury or surgery, in which case the hole would be allowed to heal and close up on its own over time. For other patients, it is a permanent condition that may involve use of a tracheostomy button, or stoma button, to replace the breathing tube.

If you are having a scheduled tracheotomy procedure, your doctor will provide information and help you prepare in advance. The procedure is usually done in a hospital operating room and you will receive general anesthesia (you'll be asleep and won't feel anything). It is sometimes performed in emergency at a patient's bedside in the intensive care unit or on-site at an accident by emergency medical personnel.

Risks of a tracheostomy risks

The level of risk involved in the procedure and afterwards depends on the level of emergency and also how long the tracheostomy will remain. Early complications include air getting trapped:

  • Around the lungs
  • In the deeper layers of the chest
  • Beneath the skin around the opening

There is also risk of:

  • Bleeding
  • Clotting, mucus and other blockage of airway walls
  • Vocal cord nerve injury

There is longer term risk of infection, damage to the windpipe, scar tissue buildup, and accidental decannulation (removal of the trach tube).

What to expect from a tracheostomy

During your hospital stay you will be taught how to clean and care for your trach tube to help prevent infection. A nurse who specializes in tracheostomy care and/or a speech therapist will provide guidance on how to use your voice, how to eat, and how to perform other activities affected by the tracheostomy. You'll also learn how to keep the trach tube moist to ensure the air you breathe is humidified properly.


ENT (Otolaryngology) and Audiology

Main Line Health otolaryngology and audiology experts treat and manage conditions affecting your ears, nose and throat at locations in the Philadelphia area.