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Tracheotomy is the surgical creation of an opening from the outside of the neck into the windpipe. A tube is inserted into the opening to allow for normal breathing. It is done to bypass obstructions that are interfering with breathing. The opening is called a stoma or tracheostomy. A stoma may be either temporary or permanent.
In an emergency, a cricothyroidotomy may be done. This type of airway should only be used temporarily. If the airway will be needed for more than 48 hours, a standard tracheotomy will be done.
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A tracheotomy is used to create an open airway. It is done to restore normal breathing in the following situations:
- The airway is obstructed at or above the level of the larynx (voice box), due to:
- Trauma to the neck area
- Obstructing tumors in the upper airway
- Respiratory failure requiring long-term mechanical breathing assistance, as in these cases:
- Spinal cord injury in the neck area
- Severe lung infection or inflammation
- Injury to the respiratory tract due to breathing in smoke or steam or inhaling corrosive substances
- Birth defects of the trachea or larynx
- Foreign object blocking the trachea or larynx
If you are planning to have a tracheotomy, your doctor will review a list of possible complications, which may include:
- Damage to the vocal cords, vocal cord nerves, or esophagus
- Damage to the lungs
- Difficulty swallowing
- Low blood pressure
- Tracheostomy tube displacement or damage
- Scarring at the site of operation leading to closure of the tracheostomy
Some factors that may increase the risk of complications include:
- Age: infants and elderly adults
- Poor nutrition
- Recent illness, especially an upper-respiratory infection
- Long-term illnesses
- Use of certain prescription and nonprescription drugs
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