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Reasons for a tracheostomy

A tracheostomy is usually done for one of three reasons:

  1. to bypass an obstructed upper airway;
  2. to clean and remove secretions from the airway;
  3. 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
  • Laryngectomy
  • Infection, such as epiglottitis or croup
  • Subglottic Stenosis
  • Subglottic Web
  • Tracheomalacia
  • 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)