A surgical procedure practised in ENT discipline of medical science.

1. Dr.Maleka Afroz
Associate Professor, ENT
USTC, Foy’s Lake Chittagong

2. 


Endotracheal intubation
Laryngotomy or Cricothyrodotomy
Tracheostomy

4. 






To bypass Airway obstruction (Ca larynx)
Tracheobronchial toiletting (Acute
laryngotrachealbronchitis,neuroparalysis)
Tracheobronchial protection (Unconscious patient)
Patient on ventilator ( ICU)
Patients with respiratory insufficiency ( COPD)
Prior to radical Head- neck or Maxillofacial surgery
as a temporary procedure
Prior to total laryngectomy as a permanent
procedure

5. 


Emergency
Elective
Permanent

6. Obstructive –Congenital
Acquired-Traumatic
Inflammatory
Neoplastic
F.B. in larynx
Paralytic
Allergy
Non obstructive-Mentioned earlier.

7. 

A little variation is marked in the operative
techniques between emergency, elective
&permanent procedure.
As well as between child & adult
tracheostomy.

8. Steps of Tracheostomy Operation

9. 
Metallic- Outer & inner tube without cuff
though reusable.

Portex- Single tube with or without cuff,
disposable.

12. 
Care of the tube-Constant supervision for
tube blockage or tube displacement, Inner tube,
Outer tube, Cuff, Suction clearance, Humidification.


Care of the wound-Regular dressing.
Care of the patient- Breathing exercise, Pen
& Paper, Bell.

13. 
Immediate- Hemorrhage, Aphonia, Apnoea, Injury to
Structures around (apical pleura, nerve, esophagus,
cricoid cartilage, fist tracheal ring), surgical emphysema,
Tube displacement.

Intermediate- Tube blockage, Chest infection, wound
infection.

Late- Layrngeal stenosis, Tracheal stenosis, Tracheo
oesophageal fistula, Tracheo cuteneous fistula, Difficult
decannulation.