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Trachestomy


 The process of making an opening made in the trachea is called  tracheostomy.

Indication

  • choking of the larynx due to dentures, foreign bodies, fish bones
  • Diphtheria
  • Carcinoma of larynx
  • Coma
  • Tetanus
  • Barbiturate poisoning
  • Head injury
  • Pulmonary insufficiency

Position

Supine with extension of neck

Anesthesia

Local

Procedure

  • Painting, drapping & isolation of part
  • Infiltrate xylocaine 2%
  • Transverse curved incision about 6cm at the level of second tracheal ring.
  • Skin, subcutaneous tissue & deep fascia are incised.
  • Isthmus of thyroid is seperated.
  • A transverse cut is made in the second tracheal cartilage & edge of the cartilage is held with Allis forceps & a small cuff of cartilage is removed.
  • A suitable sized trachestomy tube is introduced within the transverse cut.
  • Confirm that the tube is in the trachea
  • confirmed air entry on both sides of lung 
  • Few interrupted skin sutures are made at the sides of the tracheostomy tube & dressing is applied.
  • Suction of tracheostomy tube is done & regular dressing is essential.

Complications

  • Infection
  • Air leakage
  • Cricoid stenosis 

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