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A tracheostomy is usually done for one of three reasons:
- to bypass an obstructed upper airway;
- to clean and remove secretions from the airway;
- to more easily, and usually more safely, deliver oxygen to the lungs.
All tracheostomies are performed due to a lack of air getting to the lungs. There are many reasons why sufficient air cannot get to the lungs.
Airway Problems That May Require a Tracheostomy
- Tumors, such as cystic hygroma
- Infection, such as epiglottitis or croup
- Subglottic Stenosis
- Subglottic Web
- Vocal cord paralysis (VCP)
- Laryngeal injury or spasms
- Congenital abnormalities of the airway
- Large tongue or small jaw that blocks airway
- Treacher Collins and Pierre Robin Syndromes
- Severe neck or mouth injuries
- Airway burns from inhalation of corrosive material, smoke or steam
- Obstructive sleep apnea
- Foreign body obstruction
Lung Problems That May Require a Tracheostomy
- Need for prolonged respiratory support, such as Bronchopulmonary Dysplasia (BPD)
- Chronic pulmonary disease to reduce anatomic dead space
- Chest wall injury
- Diaphragm dysfunction
Other Reasons for a Tracheostomy
- Neuromuscular diseases paralyzing or weakening chest muscles and diaphragm
- Aspiration related to muscle or sensory problems in the throat
- Fracture of cervical vertebrae with spinal cord injury
- Long-term unconsciousness or coma
- Disorders of respiratory control such as congenital central hypoventilation or central apnea
- Facial surgery and facial burns
- Anaphylaxis (severe allergic reaction)
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