A tracheotomy is the procedure in which a hole is made into the trachea to either bypass an obstruction above the area it is placed to help a child breath or to assist breathing in a child that’s lungs or lower airway do not allow them to breath on their own yet. A tracheostomy is the hole that is made during the operation.
The most common reason for tracheostomy is prolonged ventilation secondary to either 1) anticipated long-term cardiorespiratory problems resulting in the need for a ventilator or 2) the presence of a fixed upper airway obstruction that is unlikely to resolve for a significant period of time. In many children this is the safest and most confortable option for varying amounts of time depending on their condition.
Despite tracheotomy being a lifesaving procedure, tracheostomy-related mortality rates range from 0.5% to 3.6%. Complications can include catastrophic plugging, accidental decannulation (removal of the tracheostomy tube), stomal granuloma (scar tissue) formation, and minor to fatal bleeding.In addition, the social stigma as well as financial costs of care and equipment can be burdensome.
It is for the above reasons and many others that decannulation (permanent removal of the tracheostomy tube) is frequently desired by both family and physicians alike. However, it is important that the procedure and later decannulation occur only after being determined safe and appropriate.
At Michigan Pediatric Ear, Nose and Throat Associates (MPENTA) our team of experienced surgeons are skilled in both the tracheotomy procedure, treatment of the tracheostomy tube placed and when it can be removed. We perform this procedure on children countless times per year and are skilled in all aspects of the associated management. We work with the family, nurses, associated physicians, home healthcare and the hospital to ensure the safest placement and later removal of the tracheostomy tube.
