What Is a Tracheostomy?

A tracheostomy (TRA-ke-OS-to-me) is a surgically made hole that goes through the front of your neck and into your trachea (TRA-ke-ah), or windpipe. The hole is made to help you breathe.

A tracheostomy usually is temporary, although you may have one long term or even permanently. How long you have a tracheostomy depends on the condition that required you to get it and your overall health.

Overview

To understand how a tracheostomy works, it helps to understand how your airways work. The airways are pipes that carry oxygen-rich air to your lungs. They also carry carbon dioxide, a waste gas, out of your lungs.

The airways include your:

• Nose and linked air passages (called nasal cavities)
• Mouth
• Larynx (LAR-ingks), or voice box
• Trachea, or windpipe
• Tubes called bronchial tubes or bronchi, and their branches

Air first enters your body through your nose or mouth. The air then travels through your voice box and down your windpipe. The windpipe splits into two bronchi that enter your lungs. (For more information, see the Diseases and Conditions Index How the Lungs Work article.)

A tracheostomy provides another way for oxygen-rich air to reach your lungs, besides going through your nose or mouth. A breathing tube, also called a trach (trake) tube, is placed through the tracheostomy and directly into the windpipe to help you breathe.

Tracheostomy is done for a number of reasons. Usually, it's done because a person needs to be on a ventilator (VEN-til-a-tor) for more than 1 to 2 weeks. A ventilator is a machine that helps you breathe. With a tracheostomy, the trach tube connects you to the ventilator.

You also may need a tracheostomy if you have a condition that interferes with coughing or blocks your upper airways. Coughing is a natural reflex that protects your lungs. It helps clear mucus (a slimy substance) and bacteria from your airways. A trach tube can be used to help remove, or suction, mucus from your airways.

Less often, people who have swallowing problems due to strokes or other conditions may have tracheostomies.

Outlook

Creating a tracheostomy is a fairly common, simple procedure. It's one of the most common procedures for critical care patients in hospitals.

Because the windpipe is located almost directly under the skin of the neck, a surgeon often can create a tracheostomy fairly quickly and easily.

While the procedure to create a tracheostomy usually is done in a hospital operating room, it also can be safely done at a patient's bedside. Less often, a doctor or emergency medical technician may create a tracheostomy in a life-threatening situation, such as at the scene of an accident or other emergency.

The procedure generally is very safe, but it can lead to various complications, including bleeding, infection, and other, more serious problems. The risk of complications often can be reduced with proper care and handling of the tracheostomy and the tubes and other related supplies.

Some people continue to need tracheostomies even after they leave the hospital. Hospital staff will teach the patients and their families or caregivers how to properly care for their tracheostomies at home.

August 2009