Tracheostomy

Excerpt

Tracheostomy is one of the earliest surgical procedures recorded, with illustrations depicting it as early as 3600 B.C. in ancient Egypt. A tracheostomy (or tracheotomy, while there are technical differences, these terms are colloquially used interchangeably. For the purposes of this article, we will use 'tracheostomy') is a surgical procedure to create an opening in the anterior trachea to facilitate respiration. Historically, a tracheostomy represented the only treatment available for upper airway obstruction, and this remains an important indication for tracheostomy today, though there are numerous others. A tracheostomy may be required in an emergent setting to bypass an obstructed airway or (more commonly) may be placed electively to facilitate mechanical ventilation, to wean from a ventilator, or to allow more efficient management of secretions (referred to as pulmonary toilet), among other reasons. Traditionally, a tracheostomy is performed as an open surgical procedure. However, safe and reliable percutaneous tracheostomy techniques have been relatively developed, allowing for the bedside placement of a tracheostomy in many patients.