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Tracheotomy

What is a tracheotomy?

A tracheotomy is a procedure to introduce a breathing tube through the skin of the neck into the windpipe.  It is performed in children with significant blockages of the airway in the voice box or upper windpipe.  This typically occurs in newborns with scarring of the airway from long term intubation.  Other children may require a tracheotomy for airway control after severe trauma or during treatment of a tumor.

Tracheotomy is often performed in children staying in the pediatric intensive care unit.  The procedure is performed in the operating room under general anesthesia, and is often done in conjunction with a formal airway evaluation of the voice box and windpipe (microlaryngoscopy and bronchoscopy). All children receiving a tracheotomy stay in the pediatric intensive care unit until the tube is changed for the first time.

A tracheotomy is not meant to be a permanent entity.  It is used to be a bridge to a later date when the child has either outgrown the problem or grown enough to tolerate procedures aimed at relieving the problem that lead to the tracheotomy in the first place. Despite this, certain children develop permanent conditions that require long term tracheotomy.

Children with a tracheotomy tube is cared for in a multidisciplinary manner, meaning that a team of doctors work together to ensure that all of the patient and family’s needs are addressed.  When children no longer require the tracheotomy tube, removal of a tracheotomy tube (decannulation) is also handled in this manner, enhancing the chances of overall success.