Indications and Procedural Steps of Tracheostomy

Preoperative Assessment

Patient Selection

Tracheostomy is indicated in patients with prolonged respiratory failure requiring ventilation support, upper airway obstruction, or secretion management issues. Candidates should be assessed based on their clinical condition, underlying pathology, and expected prognosis.

Anatomical Considerations

Key anatomical landmarks include the thyroid cartilage, cricoid cartilage, and tracheal rings. Preoperative evaluation should consider neck mobility, prior surgeries, and anatomical anomalies.

Preoperative Imaging

Imaging such as CT scans and X-rays may be required to assess tracheal anatomy, detect anomalies, and plan the surgical approach.

Procedural Steps

Preparation

• Patient positioning: Supine with neck extension
• Local or general anesthesia based on clinical status
• Sterile field preparation

Surgical Technique

• Midline incision over trachea
• Dissection to expose tracheal rings
• Tracheostomy tube insertion
• Securing the tube and confirming placement

Postoperative Care

Care includes monitoring for complications, ensuring proper humidification, suctioning to prevent blockage, and assessing for infection or bleeding.

Complications

• Bleeding
• Infection
• Tracheal stenosis
• Tube displacement