Tracheostomy is a surgical procedure that creates an opening in the neck to bypass an obstruction in the upper airway, remove secretions, or provide efficient air delivery. A tracheostomy tube is inserted into the stoma to keep the airways open. Different types of tubes are used depending on the patient’s condition. A tracheostomy tube holder can be used to stabilize the tube. Tube maintenance is required, and patients may need to learn how to do it themselves.
A tracheostomy is a surgical procedure that makes an opening, called a stoma, in the neck that leads to the windpipe. This procedure is done to bypass an obstruction in the upper airway between the mouth and lungs, to cleanse and remove any secretions that may be blocking the airways, or to provide a more efficient method of delivering air to the lungs. In this procedure, a tube, called a tracheostomy tube, is then inserted into the stoma and directly into the windpipe to help keep the airways open for breathing.
Typically, a tracheostomy tube consists of an inner tube and an outer tube — called an inner tube and an outer tube — along with an obturator. The obturator acts as a guide for the outer tube during insertion. It is then removed after insertion, leaving the outer tube in place to act as a passageway for air to pass through. In some cases, a single cannula tube without an inner tube is used. This method is often used for young children who require this procedure.
Some varieties of tubes may be used depending on the nature and severity of the problem afflicting the patient. A cuffed tracheostomy tube is often needed to allow mechanical ventilation for patients with severe respiratory insufficiency. Generally, a tracheostomy tube cuff can be inflated via a variety of methods, and once inflated, the cuff inflates like a small balloon and allows for mechanical ventilation. Fenestrated tracheotomy tubes are helpful in some cases because they allow patients to regain speech through an opening in the tube that allows air through the upper airway.
There is also a device called a tracheostomy tube holder. Holders can be used to stabilize a tracheostomy tube by securing it with hooks attached to the neck flange of the tube. Supports fit around the neck and are usually made of a soft material, such as cotton, that provides comfort for the patient without damaging the skin.
A tracheostomy tube requires maintenance that varies according to the severity of the problem. There are cases where a patient improves to the point where a tube is no longer needed, at which point it is removed, leaving a scar in the original stoma area. Most cases require the tubes to be long term. The starter tube is usually replaced about two weeks after surgery, and if patients need a tube for an extended period of time, they may need to learn how to do tube maintenance themselves. This could include activities such as suctioning the trachea or even cleaning and replacing the tube.
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