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What Is a Tracheotomy?
A Tracheotomy is a surgical procedure on the neck to open a
direct airway through an incision in the (the windpipe). The surgeon inserts a
tube into the opening to bypass an obstruction, allow air to get to the lungs,
or remove secretions. Tracheotomy is also commonly known as a
When Is a Tracheotomy Necessary?
A tracheotomy is performed if enough air is not getting to
the lungs, if the person cannot breathe without help, or is having problems with
mucus and other secretions getting into the windpipe because of difficulty
swallowing. There are many reasons why air cannot get to the lungs. The
patient's windpipe may be blocked by a swelling; by a severe injury to the neck,
nose or mouth; by a large foreign object; by paralysis of the throat muscles; or
by a tumor.
How is a Tracheostomy Preformed?
An incision is made in the neck and the muscles and connective tissue around the windpipe are pulled apart. A section at the front of the windpipe is removed. A tracheostomy tube, which will act as the airway, is fitted into this opening in the windpipe. The skin is closed around the tube with stitches or clips, which can be removed about one week after surgery.
People will breathe through this tube as long as it is in place. Oxygen and mechanical assisted breathing can be provided, if necessary.
People will not be able to speak when
the tube is in place unless they put a finger covering over the tube because all air
going in and out of the tube bypasses the vocal cords.
Options to talk with a Tracheostomy
tracheostomy tube by holding a finger or placing a cap over the tube for short
periods of time
Electrolarynx or Artificial larynx is a hand held device placed on the neck surface that vibrates when activated and mechanically resonates when words or sounds are mouthed.
A talking tracheostomy tube. Speech is obtained through a line directly above the cuff. An outside air source is used to force air through the vocal cords.
Risks Involved with a Tracheotomy
Immediate risks there are several short-term risks
associated with tracheotomies. Severe bleeding is one possible complication. The
voice box or esophagus may be damaged during surgery. Air may become trapped in
the surrounding tissues or the lung may collapse. The tracheotomy tube can be
blocked by blood clots, mucus, or the pressure of the airway walls. Blockages
can be prevented by suctioning, humidifying the air, and selecting the
appropriate tracheotomy tube. Serious infections are rare.
Long-term risks over time, other complications may develop following a tracheotomy. The windpipe itself may become damaged for a number of reasons, including pressure from the tube; bacteria that cause infections and form scar tissue; or friction from a tube that moves too much. Sometimes the opening does not close on its own after the tube is removed. This risk is higher in tracheotomies with tubes remaining in place for 16 weeks or longer. In these cases, the wound is surgically closed.