Tracheostomy is a surgical procedure in which an opening is created in front of the neck which opens into the windpipe to provide air and oxygen to the lungs. A tracheostomy is performed usually when the person is unconscious and unable to breathe. In this case, a patient with a tracheostomy breathes through the tracheostomy tube. The tracheostomy tube which is placed after the opening of the windpipe also helps in removing the secretions of the lungs. A tracheostomy tube has to be replaced after 10 to 14 days. The procedure of tracheostomy may be temporary or permanent. It is difficult for the patient to swallow food, speak, and breathe but the patient gets used to it after some time and may perform these tasks without any great effort. Tracheostomy procedure can be very risky and can cause serious complications so proper management and regular examination is needed by the doctor to reduce the chances of severe complications. However, skilled surgeons avoid these complications in advance. Tracheostomy procedures can be a problem for newborn babies or those patients who have some kind of already existing medical condition such as diabetes and infection. So proper care is important after the procedure.
Types of Tracheostomy Treatment India
There are different types of techniques for the surgical process of tracheostomy. These are:
- Percutaneous Dilational Tracheostomy (PDT)
- Open Surgical Tracheostomy
- Emergency Tracheostomy
- Pediatric Tracheostomy
- Permanent Tracheostomy
- Fenestrated Tracheostomy
Percutaneous Dilational Tracheostomy (PDT)
This is the most traditional method of tracheostomy. In this technique, the surgeon makes a small hole in front of the to reach the windpipe of breathing. They then gently stretch the hole and insert a tube.
Open Surgical Tracheostomy
In this procedure, an incision is made in front of the neck. Then a small incision is made in the trachea, and the tracheostomy tube is inserted. This method can produce a more prominent scar in front of the neck.
Percutaneous Tracheostomy with Bronchoscopy
In this technique, the flexible tube with a camera known as a bronchoscope and the percutaneous technique of tracheostomy is used in combination. The bronchoscope allows the surgeon to see the inside of the windpipe during the surgery. It helps in placing the tracheostomy tube properly.
Emergency Tracheostomy
This procedure is performed in urgent situations when there is an immediate need for an alternative way of breathing. It is a quick and life-saving procedure that is done to make a new airway in cases of severe blockage of the nose or trauma.
Pediatric Tracheostomy
Tracheostomies in children can be a complex procedure due to their extremely small size. The procedure is performed according to the age of the child, size, and any other medical conditions.
Permanent Tracheostomy
Some patients need help breathing all the time. In these cases, doctors make a hole in the neck and put a tracheostomy tube for the person to breathe for longer periods. However, there is a requirement to replace the tube after every 2 weeks.
Procedure of Tracheostomy
The procedure of tracheostomy is as follows:
- Incision: The surgeon makes a small incision in the skin of the neck.
- Accessing the Trachea: After carefully moving aside muscles and tissues, the surgeon reaches the windpipe or the trachea.
- Creating a hole: A small hole is made in the trachea. This hole serves as the new pathway for breathing.
- Inserting the Tube: A tracheostomy tube is inserted into the trachea through the hole.
- Securing the Tube: The tube is protected in the same position by using tapes or a special holder attached around the neck.
- Verifying Placement: The medical team uses different types of techniques to confirm that the tube is properly placed in the trachea and not the esophagus. Techniques can be different such as listening for breath sounds and checking for chest movement.
- Closing the Incision: The incisions are closed by using sutures and the bandage is applied to hold the tube in position.
Post-surgical Care: Once the tube is in place, it is connected to the machine outside for breathing. The proper care of the tube and examination is important to avoid any complications.
Cost of Tracheostomy in India
The cost of tracheostomy in India ranges from 650 USD to 900 USD. The cost can vary according to the condition of each patient. The cost can also vary according to the types of technique used in surgery and the need for a ventilator alongside tracheostomy.
Tracheostomy : 650 USD - 897 USD
Indications of Tracheostomy
Some of the conditions where the tracheostomy procedure is performed are:
- Airway Blockage
- Ventilator Support
- Facial or Neck Injuries
- Long-term Breathing Problems
- Surgery or Treatment
- Swelling or Obstruction
- Management of difficulty in sleeping
- Neurological Conditions
- Severe Infections
- Cancer Management
- Facial Reconstruction
- Coma or Unconsciousness
- Critical Illness
- Swallowing Difficulties
Risk factors of Tracheostomy
Some of the risk factors that are associated with tracheostomy are described below:
Infection
The incision site or the tracheostomy tube itself can become infected. The infection can spread anywhere in the body which needs further medical attention.
Bleeding
There is a risk of bleeding during or after the procedure. In rare cases, excess bleeding may need blood transfusion and emergency treatment protocol.
Air Leak
The air might escape from the trachea into the neck tissues and can cause swelling. This can cause discomfort and pain.
Tube Obstruction
The tube can get blocked due to the secretions and may further cause complications of breathing difficulties.
Tube Displacement
The tube might move from its proper position and can irritate the surrounding structures. This can also cause injury to the structure that is close to the trachea.
Scarring
Scarring can occur around the tracheostomy site. Poor skill during the incision formation can lead to more prominent scars.
Voice Changes
Speaking can be affected due to the position of the tracheostomy tube. Some patients experience a complete change of voice.
Aspiration
Food or fluids might enter from the food pipe to the tube and into the lungs. This can lead to serious life-threatening situations.
Damage to Structures
Nearby structures like blood vessels or other tissues can be harmed during the procedure.
Tube Size Issues
The size of the tube should be according to the size of the patient. Using the wrong-sized tube can lead to many complications.
Respiratory Distress
Some patients might struggle to get used to the tube which can cause discomfort or breathing problems.
