Tracheostomy

Tracheostomy is the procedure where an opening or hole is made by the surgeon through the neck into the windpipe ( trachea ). This is done to place a tracheostomy tube into the hole, which helps the person to breathe. The tube provides an air passage for breathing, when the usual route is blocked or breathing is reduced. 

Tracheostomy is required for patients who are on ventilators or when patients have long term health disorders. Tracheostomy is the life saving emergency procedure, done when the airway of the person is suddenly blocked in cases of trauma, accidents or injuries to face and neck. 

When the patient’s health is restored, the tracheostomy site is allowed to heal and close or is surgically closed by the surgeon. In certain health conditions, tracheostomy passage is kept open permanently. 

Know More About Surgery

The various conditions where the Tracheostomy is needed are-

  • Food stuck in airway
  • Laryngeal spasm
  • Windpipe injury
  • Throat tumor
  • Vocal cord paralysis
  • Throat/ head and neck infections
  • Burn injuries
  • Ludwig’s angina ( life threatening swelling of the mouth, tongue and airway )
  • Sleep apnea
  • Head and neck surgeries
  • Birth defects that cause breathing difficulty
  • Anaphylaxis reaction ( a severe allergic reaction )
  • Other diseases which may cause breathing problems
  • Spine injury
  • Coma 
  • Laryngectomy (removal of the larynx or voice box)
  • Lung diseases, Chest wall damage, Pneumonia
  • Problems with the diaphragm (muscle below the lungs that help in breathing)
  • Heart attack or Stroke (blood supply to the brain is suddenly stopped)

 

  1. Physical examination: The doctor will check the motion of the patient’s neck. The patient will be evaluated physically and the symptoms, medical history, and family history of the patient are noted.
  2. Blood tests: It helps in the diagnosis of certain underlying medical conditions.
  3. Electrocardiogram or ECG: The electrical activity of the heart can be recorded using this test.
  4. Imaging tests: X-rays, CT scans, and MRI scans are the different types of imaging tests that help in producing clear pictures of the internal organs of the body.

 

A tracheostomy procedure is usually done under general anesthesia (the patient will be put to sleep during the procedure). However, if the surgeon is skeptical about the airway becoming compromised due to general anesthesia, or if the procedure is being performed on an emergency basis, the procedure may be performed under local anesthesia (the treatment area is numbed locally).

The type of tracheostomy performed will vary depending on the reason for undergoing the procedure, and whether the procedure was done on an emergency basis, or it was a pre-planned procedure.

Tracheostomy may be performed in the following two ways:

1. Surgical tracheostomy: 

  • The surgeon will first make a horizontal incision through the skin at the lower portion of the front of the neck.
  • The surrounding muscles will be carefully pulled back.
  • A small part of the thyroid gland is cut to expose the trachea or windpipe.
  • The surgeon will then create a tracheostomy hole at a specific spot on the trachea, near the base of the neck.
  • A tracheostomy tube will then be inserted into the hole.
  • A neck strap is then attached to the face plate of the tracheostomy tube to prevent the tube from slipping out of the hole.
  • Temporary sutures are then given to secure the faceplate to the neck skin.

2. Minimally-invasive or percutaneous tracheostomy:

  • The doctor will first make a small incision near the base of the front of the neck.
  • A special lens will then be fed through the mouth so that the surgeon can view the inside of the throat.
  • The surgeon will then guide a needle into the windpipe to create a tracheostomy hole.
  • This hole will then be expanded to an appropriate size to insert the tracheostomy tube.
  • A tracheostomy tube will then be inserted into the hole.
  • A neck strap is then attached to the face plate of the tracheostomy tube to prevent the tube from slipping out of the hole.
  • Temporary sutures are then given to secure the faceplate to the neck skin.

The risk of tracheostomy can be divided as -

1. Immediate risks: 

  • Bleeding
  • Displaced tube
  • Damage to the surrounding structures- thyroid gland, windpipe, nerves of neck
  • Air in the lungs and chest wall ( Pneumothorax ), lung collapse, breathing problems
  • Subcutaneous emphysema
  • Hematoma ( blood collection ) in the neck causing bleeding difficulties

2. The long term risks: 

  • Scarring, narrowing or damage to the trachea
  • Tracheostomy tube obstruction
  • Displaced trachea
  • Abnormal fistula formation between trachea and oesophagus,which may cause food and fluids to enter the lungs
  • Infections in the trachea and bronchial tubes
  • Infections at the site of the tracheostomy
  • Pneumonia (due to infection in the lungs)
  • A chest x-ray will be taken to check that the tracheostomy tube is in its correct place and that there are no complications.
  • Antibiotics may be given to reduce the chances of infection.
  • You will be taught how to care for and clean in and around the tracheostomy tube.
  • It may take a couple of days for you to get used to breathing through the tracheostomy tube and it may be difficult to speak at first. If the tube can allow some air to escape and then pass over the vocal cords, you will be able to speak by placing a finger over the tube.
  • Swallowing may be difficult while you are healing. During this time, you will receive nutrition intravenously (injected into the vein), through a feeding tube, or a tube that is inserted directly into the stomach. You may later need assistance from a speech therapist to help you in swallowing.
  • You will most likely be discharged from the hospital after three to five days of the tracheostomy procedure, provided that there are no complications.

Home remedies:

  1. You can use warm compresses to relieve the pain at the site of the incision.
  2. The inner cannula (tube) portion of the tracheostomy tube needs to cleanse whenever it gets blocked due to secretions. This may be needed once a day or several times a day.
  3. Keep the surgical area dry and clean. You can wear a scarf over the opening and when stepping out. Avoid any contact with food particles, water, and powdery substances.
  4. You need to have a humidifier attachment for approximately one month after the surgery because the trachea is exposed to dry air.
  5. Avoid strenuous and vigorous activities for six weeks after the surgery.


Benefits:

The advantages of tracheostomy include:

  • Improved comfort
  • Quick rehabilitation
  • Less need for sedation
  • Good nutrition
  • Early communication
  • Easy weaning off of mechanical ventilation 

Cost of tracheostomy in India- 

The cost of a tracheostomy in Mumbai is between INR 35,000 to INR 85,000.
The cost of a tracheostomy in Delhi is between INR 30,000 to INR 80,000.
The cost of a tracheostomy in Bangalore is between INR 30,000 to INR 80,000.
The cost of a tracheostomy in Chennai is between INR 25,000 to INR 75,000.

 

Top Doctors for Tracheostomy in New Delhi

{{x.doctor_name}}

{{x.qualifications}}

{{x.experience}} years experience

  • {{x.specialisation | limitTo: 1}} {{x.specialisation }}
    {{x.clinic_name}}
  • {{x.locality}}, {{x.city_name}}
  • {{y.day}}: {{y.slot}}

  • Fee INR {{x.rate}}

No Results Found!

Tracheostomy

Tracheostomy is the procedure where an opening or hole is made by the surgeon through the neck into the windpipe ( trachea ). This is done to place a tracheostomy tube into the hole, which helps the person to breathe. The tube provides an air passage for breathing, when the usual route is blocked or breathing is reduced. 

Tracheostomy is required for patients who are on ventilators or when patients have long term health disorders. Tracheostomy is the life saving emergency procedure, done when the airway of the person is suddenly blocked in cases of trauma, accidents or injuries to face and neck. 

When the patient’s health is restored, the tracheostomy site is allowed to heal and close or is surgically closed by the surgeon. In certain health conditions, tracheostomy passage is kept open permanently. 

Purpose:

  • For patients on ventilators for prolonged time.
  • Patients with vocal cord paralysis, throat cancer that block the airways.
  • Before head and neck surgery, to assist in breathing during recovery.
  • Nerve disorders, paralysis, etc that need suctioning out of the airway to clear the windpipe.
  • Trauma / head injury that causes obstruction in breathing
  • Other health conditions, where breathing tubes can not be passed through the mouth into the trachea. 

Symptoms

The various conditions where the Tracheostomy is needed are-

  • Food stuck in airway
  • Laryngeal spasm
  • Windpipe injury
  • Throat tumor
  • Vocal cord paralysis
  • Throat/ head and neck infections
  • Burn injuries
  • Ludwig’s angina ( life threatening swelling of the mouth, tongue and airway )
  • Sleep apnea
  • Head and neck surgeries
  • Birth defects that cause breathing difficulty
  • Anaphylaxis reaction ( a severe allergic reaction )
  • Other diseases which may cause breathing problems
  • Spine injury
  • Coma 
  • Laryngectomy (removal of the larynx or voice box)
  • Lung diseases, Chest wall damage, Pneumonia
  • Problems with the diaphragm (muscle below the lungs that help in breathing)
  • Heart attack or Stroke (blood supply to the brain is suddenly stopped)

 

Diagnosis

  1. Physical examination: The doctor will check the motion of the patient’s neck. The patient will be evaluated physically and the symptoms, medical history, and family history of the patient are noted.
  2. Blood tests: It helps in the diagnosis of certain underlying medical conditions.
  3. Electrocardiogram or ECG: The electrical activity of the heart can be recorded using this test.
  4. Imaging tests: X-rays, CT scans, and MRI scans are the different types of imaging tests that help in producing clear pictures of the internal organs of the body.

 

Treatment

A tracheostomy procedure is usually done under general anesthesia (the patient will be put to sleep during the procedure). However, if the surgeon is skeptical about the airway becoming compromised due to general anesthesia, or if the procedure is being performed on an emergency basis, the procedure may be performed under local anesthesia (the treatment area is numbed locally).

The type of tracheostomy performed will vary depending on the reason for undergoing the procedure, and whether the procedure was done on an emergency basis, or it was a pre-planned procedure.

Tracheostomy may be performed in the following two ways:

1. Surgical tracheostomy: 

  • The surgeon will first make a horizontal incision through the skin at the lower portion of the front of the neck.
  • The surrounding muscles will be carefully pulled back.
  • A small part of the thyroid gland is cut to expose the trachea or windpipe.
  • The surgeon will then create a tracheostomy hole at a specific spot on the trachea, near the base of the neck.
  • A tracheostomy tube will then be inserted into the hole.
  • A neck strap is then attached to the face plate of the tracheostomy tube to prevent the tube from slipping out of the hole.
  • Temporary sutures are then given to secure the faceplate to the neck skin.

2. Minimally-invasive or percutaneous tracheostomy:

  • The doctor will first make a small incision near the base of the front of the neck.
  • A special lens will then be fed through the mouth so that the surgeon can view the inside of the throat.
  • The surgeon will then guide a needle into the windpipe to create a tracheostomy hole.
  • This hole will then be expanded to an appropriate size to insert the tracheostomy tube.
  • A tracheostomy tube will then be inserted into the hole.
  • A neck strap is then attached to the face plate of the tracheostomy tube to prevent the tube from slipping out of the hole.
  • Temporary sutures are then given to secure the faceplate to the neck skin.

Risks

The risk of tracheostomy can be divided as -

1. Immediate risks: 

  • Bleeding
  • Displaced tube
  • Damage to the surrounding structures- thyroid gland, windpipe, nerves of neck
  • Air in the lungs and chest wall ( Pneumothorax ), lung collapse, breathing problems
  • Subcutaneous emphysema
  • Hematoma ( blood collection ) in the neck causing bleeding difficulties

2. The long term risks: 

  • Scarring, narrowing or damage to the trachea
  • Tracheostomy tube obstruction
  • Displaced trachea
  • Abnormal fistula formation between trachea and oesophagus,which may cause food and fluids to enter the lungs
  • Infections in the trachea and bronchial tubes
  • Infections at the site of the tracheostomy
  • Pneumonia (due to infection in the lungs)

After Procedure

  • A chest x-ray will be taken to check that the tracheostomy tube is in its correct place and that there are no complications.
  • Antibiotics may be given to reduce the chances of infection.
  • You will be taught how to care for and clean in and around the tracheostomy tube.
  • It may take a couple of days for you to get used to breathing through the tracheostomy tube and it may be difficult to speak at first. If the tube can allow some air to escape and then pass over the vocal cords, you will be able to speak by placing a finger over the tube.
  • Swallowing may be difficult while you are healing. During this time, you will receive nutrition intravenously (injected into the vein), through a feeding tube, or a tube that is inserted directly into the stomach. You may later need assistance from a speech therapist to help you in swallowing.
  • You will most likely be discharged from the hospital after three to five days of the tracheostomy procedure, provided that there are no complications.

Home remedies:

  1. You can use warm compresses to relieve the pain at the site of the incision.
  2. The inner cannula (tube) portion of the tracheostomy tube needs to cleanse whenever it gets blocked due to secretions. This may be needed once a day or several times a day.
  3. Keep the surgical area dry and clean. You can wear a scarf over the opening and when stepping out. Avoid any contact with food particles, water, and powdery substances.
  4. You need to have a humidifier attachment for approximately one month after the surgery because the trachea is exposed to dry air.
  5. Avoid strenuous and vigorous activities for six weeks after the surgery.


Benefits:

The advantages of tracheostomy include:

  • Improved comfort
  • Quick rehabilitation
  • Less need for sedation
  • Good nutrition
  • Early communication
  • Easy weaning off of mechanical ventilation 

Cost of tracheostomy in India- 

The cost of a tracheostomy in Mumbai is between INR 35,000 to INR 85,000.
The cost of a tracheostomy in Delhi is between INR 30,000 to INR 80,000.
The cost of a tracheostomy in Bangalore is between INR 30,000 to INR 80,000.
The cost of a tracheostomy in Chennai is between INR 25,000 to INR 75,000.

 

FAQ Section

1) What is Tracheostomy?

Tracheostomy is the procedure done where an opening is created in front of the neck so that a tube can be inserted into the windpipe ( trachea) , that helps in breathing. In emergency cases, the tube is connected to the oxygen cylinder and to a breathing machine called a ventilator. 

 

2) What is the purpose of the tracheostomy?

Tracheostomy is done for basic 3 purposes- 

  • To make a bypass through the obstructed upper airway
  • Clean and remove the secretions from the airway
  • Deliver oxygen to the lungs

3) Is tracheostomy a major surgery?

Tracheostomy is a common but major surgery, which may have certain risks and complications. 

 

4) Is tracheostomy painful ?

Planned tracheostomy is done under general anesthesia, that is the patient will remain unconscious during the procedure and will not feel any pain. The doctor will first make an incision in the throat and then insert the tracheostomy tube. 

5) Can a patient speak after the tracheostomy tube is removed ?

The patient is advised to cover or occlude the tracheostomy hole while speaking or coughing, after the tube is removed and skin edges are taped. The wound heals in 5-7 days. 

 

6) In what condition tracheostomy is needed?

Tracheostomy is needed in conditions like- Laryngeal spasm, Windpipe injury, Throat tumor, Vocal cord paralysis, Throat/ head and neck infection, Burn injuries, etc to name few. 

 

7) What are the complications of the tracheostomy?

The complications of tracheostomy may include- bleeding, damage to the surrounding structures in the neck, air in lungs, hematoma, damage to trachea, tracheal infections, displaced trachea, fistula between trachea and food pipe, pneumonia, lung infections, etc. 

 

8) What are the 2 types of tracheostomy?

The 2 types of tracheostomy are - Surgical Tracheostomy and Minimally Invasive Tracheostomy

 

9) Why is permanent tracheostomy needed?

Permanent tracheostomy is needed when the person has damage or loss of function around the larynx or swallowing area, that will help the person to breathe at night. However the speech of the person, eating and drinking is also affected. 
 

 

10) What is the survival rate after the tracheostomy?

The average survival rate after the tracheostomy is 65% by 1 year and 45% by 2 years. Survival rate is shorter in patients after 60 years. 

11) What is the cost of Tracheostomy in India?

The cost of Tracheostomy in India varies across different cities and hospitals-

Cost of Tracheostomy in India
CITY COST
Cost of Tracheostomy in Mumbai       INR 25000- INR 85000
Cost of Tracheostomy in Bangalore INR 24000- INR 84000
Cost of Tracheostomy in Delhi INR 24000- INR 84000
Cost of Tracheostomy in Chennai INR 23000- INR 83000

 

Q. What is the difference between a tracheotomy and a tracheostomy?

A. Tracheotomy is the incision or cut created by the surgeon in the windpipe. Tracheostomy refers to the opening or stoma itself. However, many doctors use the two terms interchangeably.

 

Q. Who performs a tracheostomy?

A. Tracheostomy is generally performed by an ENT specialist or otolaryngologist.

Q. Is tracheostomy a permanent procedure?

A. No, when a tracheostomy is no longer required, the doctor can remove the tracheostomy tube. The hole usually closes on its own. If the hole does not close, the surgeon can close it up.

 

Q. Can I talk after having a tracheostomy?

A. Yes, you can talk after a tracheostomy, but it will need some practice. You can talk by covering the tracheostomy hole with a finger and then forcing the air out through the mouth.
Speech therapy techniques can help you in speaking with a tracheostomy tube. Speaking valves can also help you in talking. They allow you to talk without using the finger to cover the tracheostomy hole.

Q. Can I breathe on my own with a tracheostomy?

A. Yes, most people can breathe on their own with a tracheostomy. Since the tracheostomy bypasses the nose, mouth, and throat, it will allow the air to go directly into the lungs.
If you are unable to breathe entirely on your own, the tracheostomy tube can be attached to a ventilator or breathing machine. This will increase the oxygen flow to the lungs.

 

Q. How often will I need to clean the tracheostomy tube?

A. Depending on the guidelines of the manufacturer and the doctor, as well as your own condition, the number of times a tracheostomy tube needs to be cleaned in a day varies from patient to patient. Typically, a tracheostomy tube needs to be cleaned at least once a day, although the inner cannula or tube of the tracheostomy tube needs to be cleaned or replaced more frequently.