Why Do People Have a Tracheotomy?

After his tragic accident, late actor Christopher Reeve underwent a tracheotomy.
After his tragic accident, late actor Christopher Reeve underwent a tracheotomy. (Image: Getty Images/Getty Images News/Getty Images)

A tracheotomy is an opening in the neck that leads directly to the windpipe, or trachea. The surgeon makes this hole, then inserts a plastic, hollow tube, called a tracheotomy tube, into the opening. MedicineNet.com warns that because doctors perform this procedure on a group of people who are, by their very nature, very ill to begin with -- complications, some of which are deadly -- are likely. The website lists loss of blood, infection and damage to the voice box among some of the difficulties that can arise from this surgery. A number of events can take place to necessitate this procedure.

Needing a Ventilator

Doctors perform tracheotomies on patients who need a ventilator, or breathing machine, for more than two weeks. As the David Darling Encyclopedia of Science says, the tracheotomy's purpose is to connect the patient to the breathing apparatus. The tracheotomy, or trach, will allow the patient to eat and speak while temporarily using the device.

Coughing Problems

A doctor may also prescribe a tracheotomy for a patient who has trouble coughing because mucus has blocked her airways. The Science Encyclopedia points out a number of conditions which might impair this natural reflex, including: congenital, or present at birth, defects of the upper airways and injuries due to smoke, steam or other chemical burns.

Swallowing Difficulties

If the patient has had a stroke, she may temporarily develop problems swallowing. This condition hinders the natural flow of the saliva necessary for moistening the mouth and will also prevent the normal swallowing and digestion of food. Thus the surgeon may install a tracheotomy until the patient is able to resume normal swallowing.

Cancer of the Larynx

Whether a laryngeal cancer patient needs a temporary or permanent tracheostomy, depends on how large a portion of the larynx the surgeon must remove due to the size of the area of the voice box the malignancy covers. If the cancer resides in a specific part of the larynx, he will perform a partial laryngectomy, which usually will require the patient to have a tracheotomy for a short time while the patient heals. However, in the case of a full laryngectomy, the doctor must remove the voice box, because in his opinion, the cancer is too widespread. According to the Macmillan Cancer Support website, with the larynx completely gone, the natural connection between the nose, the mouth and the lungs no longer exists. Thus the doctor must cut a hole in the throat -- a permanent one -- to provide the patient with a way to breathe after the surgery.

Emergency Situations

An emergency, such as a car accident, can lead to the necessity of a tracheotomy. However, according to the Mayo Clinic website, the performance of the procedure outside of the hospital is hard and can lead to many complications. Therefore, the surgeon present at the scene of the crash may perform a cricothyroidostomy, where he drills a hole directly into the patient's voice box. After the patient arrives at the hospital, the doctor will check him over to determine if he needs long-term breathing help. If, in the physician's opinion, the patient will require such assistance, the doctor will perform a tracheotomy once the patient's condition is stable.

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