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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 can 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 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 enters your body through your nose or mouth. The air travels through your voice box and down your windpipe. The windpipe splits into two bronchi that enter your lungs. (For more information, go to the Health Topics 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 put through the tracheostomy and directly into the windpipe to help you breathe.

Doctors use tracheostomies for many reasons. One common reason is to help people who need to be on ventilators (VEN-til-a-tors) for more than a couple of weeks.

Ventilators are machines that support breathing. If you have a tracheostomy, the trach tube connects to the ventilator.

People who have conditions that interfere with coughing or block the upper airways also may need tracheostomies. Coughing is a natural reflex that protects the lungs. It helps clear mucus (a slimy substance) and bacteria from the airways. A trach tube can be used to help remove, or suction, mucus from the airways.

Doctors also might recommend tracheostomies for people who have swallowing problems due to strokes or other conditions.

Outlook

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

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

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

As with any surgery, complications can occur, such as bleeding, infection, and other serious problems. The risks 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 patients and their families or caregivers how to properly care for their tracheostomies at home.

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March 19, 2012