Tracheostomy: Symptoms Complications and Treatment

Contents

In this article we will look at:

• What is tracheostomy?
• How is tracheostomy performed?
• Am I eligible for tracheostomy?
• What risks will I face while undergoing the tracheostomy procedure?
• What are the pre-procedure guidelines I should follow for tracheostomy?
• What are post-operative guidelines I need to follow after undergoing an tracheostomy procedure?
• What is the recovery period after undergoing a tracheostomy procedure?
• Are the results of tracheostomy permanent?

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What is a tracheostomy?

A tracheostomy is a surgical procedure wherein a tube is placed in the patient’s windpipe to help the person breathe while bypassing the nose, mouth and throat. This tube may be placed temporarily or permanently. This procedure is also referred to as a stoma. It is performed in an operation theatre while the patient is under general anaesthesia. In case of an emergency, the patient may be given local anaesthesia to numb the neck.

How is tracheostomy performed?

At the outset, the patient is administered general anaesthesia. Once the patient is asleep, the surgeon will make an incision just below the Adam’s apple. This cut will go through the outer walls of the trachea. It is then widened so as to be able to fit a tracheostomy tube. Once the tube is inserted, it may be connected to a ventilator if needed. A band will be placed around the neck to hold the tube in place while the skin heals around the incision.

Am I eligible for tracheostomy?

You are eligible for tracheostomy if:

• You have a birth defect in your airways
• You have burnt your airways by inhaling corrosive materials
• You have neck cancer
• You suffer from chronic lung disease
• You have facial burns
• You have an injury in the larynx or chest wall
• You have severe mouth or neck injuries
• You have paralysis of the muscles needed to swallow
• You have obstructive sleep apnoea
• You have vocal cord paralysis
• You need prolonged ventilator support
• You are in a coma

What risks will I face while undergoing the tracheostomy procedure?

The risks of tracheostomy include:

• Bleeding
• Allergic reaction to anaesthesia
• Lung puncture
• Lung collapse
• Air trapped in the lungs
• Air trapped under the skin around the incision site
• Scar tissue development in the trachea
• Damage to the thyroid gland
• Erosion of the trachea
• Blockage of the tracheostomy tube by mucus, blood clots or pressure on the walls of the airway
• The risks of undergoing this procedure are considered higher for
• Newborns and infants
• Smokers
• Alcoholics
• Diabetics
• Patients with compromised immune systems
• Patients with respiratory infections
• Patients taking cortisones or steroids

What are the pre-procedure guidelines I should follow for tracheostomy ?

Before you undergo surgery, you must tell the doctor about any medication you are currently taking. Some medication may be changed or stopped for a few days before the procedure. You will also be told to fast for up to 12 hours before the procedure.

What are post-operative guidelines I need to follow after undergoing tracheostomy procedure?

The post-operative guidelines for tracheostomy include:

• Hospitalization for several days as the body heals. During this time, the patient will be given medication to relieve pain and discomfort.
• The patient will be taught how to clean and change the tracheostomy tube. It will need to be cleaned and changed at regular intervals depending on the type of tube.
• The patient may need to consult a speech therapist to learn how to use their voice again or to find other options for communication.
• In the initial days after the procedure, an IV will supply the body with its nutritional needs. Later, the speech therapist will work with the patient to help them regain control of the muscles required for swallowing
• Saline nebulizer treatment may be required from time to time to add moisture to the air entering the lungs.
• If the tube is needed only temporarily but kept in place for more than 16 weeks, further surgery may be needed to surgically close the incision.

What is the recovery period after undergoing tracheostomy procedure? 

Most patients take about 2 weeks to recover fully.

Are the results of tracheostomy permanent? 

A tracheostomy tube may be inserted temporarily or permanently. If the tube is inserted temporarily, when it is removed, a small scar may be left in its place. In cases where the tube is inserted permanently, the patient will have to adapt to speaking and eating with the tube.