Tracheostomy cost in India

Know More About Procedure & Surgery

What is tracheostomy?

A tracheostomy is a medical procedure — either temporary or permanent — that involves creating an opening in the neck in order to place a tube into a person’s windpipe. The tube is inserted through a cut in the neck below the vocal cords. This allows air to enter the lungs. Breathing is then done through the tube, bypassing the mouth, nose, and throat. A tracheostomy is commonly referred to as a stoma. This is the name for the hole in the neck that the tube passes through.

Why is it done?

Conditions that may require a tracheostomy include:

• Anaphylaxis
• birth defects of the airway
• Burns of the airway from inhalation of corrosive material
• Cancer in the neck
• Chronic lung disease
• Coma
• Diaphragm dysfunction
• facial burns or surgery
• infection
• injury to the larynx or laryngectomy
  
• injury to the chest wall
• need for prolonged respiratory or ventilator support
  
• obstruction of the airway by a foreign body
• Obstructive sleep apnea
• Paralysis of the muscles used in swallowing
• severe neck or mouth injuries
• Tumors
• Vocal cord analysis

Risks of a tracheostomy

Every medical procedure where the skin is broken carries the risk of infection and excessive bleeding. There’s also a chance of an allergic reaction to anesthesia, although it’s rare. Tell your doctor if you’ve had an allergic reaction to anesthesia in the past.

Risks specific to a tracheostomy include:

• damage to the thyroid gland in the neck
• erosion of the trachea, which is rare
• lung collapse
• Scar tissue in the trachea

Preparation for a tracheostomy

If your tracheostomy is planned, your doctor will tell you how to prepare for the procedure. This may involve fasting for up to 12 hours before the procedure. If your tracheostomy is performed during an emergency, there will be no time to prepare.

Procedure

You’ll be given general anesthesia. This means you’ll fall asleep and won’t feel any pain. In emergencies, you’ll be injected with local anesthesia. This numbs the area of your neck where the hole is made. The procedure will begin only after the anesthesia has started working. Your surgeon will make a cut into your neck just below your Adam’s apple. The cut will go through the cartilaginous rings of the outer wall of your trachea, also known as your windpipe. The hole is then opened wide enough to fit a tracheostomy tube inside.

Your doctor may hook up the tube to a ventilator, in case you need a machine to breathe for you. The tube will be secured in place with a band that goes around your neck. This helps keep the tube in place while the skin around it heals. Your surgical team will tell you how to care for the wound and your tracheostomy tube.

Adapting to a tracheostomy tube

It typically takes one to three days to adapt to breathing through a tracheostomy tube. Talking and making sounds also takes some practice. This is because the air you breathe no longer passes through your voice box. For some people, covering the tube helps them talk. Alternately, special valves can be attached to the tracheostomy tube. While still taking in air through the tube, these valves allow air to exit the mouth and nose, permitting speech.

After the procedure

You'll likely spend several days in the hospital as your body heals. During that time, you'll learn skills necessary for maintaining and coping with your tracheostomy:

• Caring for your tracheostomy tube. A nurse will teach you how to clean and change your tracheostomy tube to help prevent infection and reduce the risk of complications. You'll continue to do this as long as you have a tracheostomy.
• Speaking. Generally, a tracheostomy prevents speaking because exhaled air goes out the tracheostomy opening rather than up through your voice box. But there are devices and techniques for redirecting airflow enough to produce speech. Depending on the type of tube, width of your trachea and condition of your voice box, you may be able to speak with the tube in place. If necessary, a speech therapist or a nurse trained in tracheostomy care can suggest options for communicating and help you learn to use your voice again.
• Eating. While you're healing, swallowing will be difficult. You'll receive nutrients through an intravenous (IV) line inserted into a vein in your body, a feeding tube that passes through your mouth or nose, or a tube inserted directly into your stomach. When you're ready to eat again, you may need to work with a speech therapist, who can help you regain the muscle strength and coordination needed for swallowing.
• Coping with dry air. The air you breathe will be much drier because it no longer passes through your moist nose and throat before reaching your lungs. This can cause irritation, coughing and excess mucus coming out of the tracheostomy. Putting small amounts of saline directly into the tracheostomy tube, as directed, may help loosen secretions. Or a saline nebulizer treatment may help. A device called a heat and moisture exchanger captures moisture from the air you exhale and humidifies the air you inhale. A humidifier or vaporizer adds moisture to the air in a room.
• Managing other effects. Your health care team will show you ways to care for other common effects related to having a tracheostomy. For example, you may learn to use a suction machine to help you clear secretions from your throat or airway.