How is a tracheostomy performed?
A tracheostomy is usually done under general anesthesia, but in emergencies, patients are administered local anesthesia.
The type of procedure depends on why a patient needs a tracheostomy and whether the procedure was planned. There are essentially two options:
- A surgical tracheotomy can be performed in an operating room or a hospital room. The surgeon usually makes a horizontal incision through the skin at the lower part of the front of your neck. The surrounding muscles are carefully pulled back, and a small portion of the thyroid gland is cut, exposing the windpipe (trachea). At a specific spot on your windpipe near the base of your neck, the surgeon creates a tracheostomy hole.
- A minimally invasive tracheotomy (percutaneous tracheotomy) is typically performed in a hospital room. The doctor makes a small incision near the base of the front of the neck. A special lens is fed through the mouth so that the surgeon can view the inside of the throat. Using this view of the throat, the surgeon guides a needle into the windpipe to create the tracheostomy hole, then expands it to the appropriate size for the tube.
For both the procedures, the surgeon inserts a tracheostomy tube into the hole. A neck strap attached to the faceplate of the tube keeps it from slipping out of the hole, and temporary sutures can be used to secure the faceplate to the skin of your neck.