Definition : An opening made in the trachea is called tracheostomy.
- Emergency: choking, stridor
- Elective: Coma , tetanus, barbiturate,head injuries, pulmonary insufficiency
- Anaplastic carcinomathyroid patients presenting with stridor due to infiltration of growth into trachea.
- Incision: Tranverse curved incision 3-4cm at the level of 2nd tracheal ring.
- Dissection: Skin , subcutaneous tissue and deep fascia are incised.Isthmus of thyroid is separated.
- Procedure: A transversed curved cut is made at the level of 2nd tracheal ring, its edge is held by Allis forceps and a small cuff of cartilage is removed. Cricoid hook can be used to stabilise the trachea (found more usefull in children).
- A suitable sized tracheostomy is introduced within.
- The cuff of tracheostomy tube is inflated by using 2-5ml of air and is held in place by passing a tape around the neck.
- Confirm the tube in the trachea not in the subcutaneous plane.
- Confirm air entry into both lungs.
Post op Rx
- Suction of tracheostomy tube
- Regular dressing
- Humidification of air
- Check for air entry
Post op complication
- wound infection
- Air leakage
- Improper air entry
- cricoid stenosis