Fast Facts on Tracheotomies

Feb. 24, 2005 — -- Pope John Paul II underwent a tracheotomy today to help him breathe more easily, the Vatican said. The following are some facts about tracheotomies, their history and the risks and benefits of this operation.

A tracheotomy is a surgical procedure in which a cut or opening is created through the neck into the trachea (commonly known as the windpipe).

A tube is placed through this opening to provide an airway to the lungs, to bypass an obstruction or to remove secretions from the lungs. The tube is shaped like a large piece of elbow macaroni.

The tube is called a tracheotomy tube or trach tube.

The term tracheostomy is sometimes used interchangeably with tracheotomy.

The operation is normally performed under general anesthesia.

During the operation, the trach tube is connected to a respirator. Following the operation, the patient is gradually weaned off the respirator. Doctors may take the patient off the respirator within a few hours of the procedure. In some cases, the patient may remain connected to a respirator for several days or weeks.

A tracheotomy may be performed for several reasons: long-term unconsciousness or coma, paralysis of the muscles that affect swallowing, obstruction of the airway, severe neck or mouth injuries, or inhalation of corrosive material, smoke or steam.

Some tracheotomies are temporary; the tube will eventually be removed and healing will occur quickly, leaving a small scar.

If the tracheostomy tube is more permanent, the hole remains open and may require surgical closure.

Most patients require one to three days to adapt to breathing through a tracheotomy tube.

It may be difficult or impossible for the patient to talk or make sounds at first, though most patients can learn to talk with a trach tube.

Many patients will initially require feeding through a feeding tube placed through the nose or mouth.

Following a successful tracheotomy, most activities can be resumed.

Patients must adhere to some safety precautions regarding exposure to water, aerosols, powder and food particles.

Some of the common risks of a tracheostomy include infection following surgery and bleeding from the skin or a major blood vessel. General anesthesia may also present a risk to some patients.

The first recorded tracheotomy took place around 2000 B.C. About 400 B.C., Hippocrates condemned tracheotomy, noting the procedure posed a threat to arteries in the neck.

Sources: National Institutes of Health; Dr. Charles E. Morgan and Dr. Susan Dixon, University of Alabama at Birmingham School of Medicine; American Thoracic Society; Dr. Paul A. Taheri, University of Michigan Health System