A surgical procedure that consists of making an incision on the anterior aspect of the neck and opening a direct airway through an incision in the trachea. The resulting stoma can serve independently as an airway or as a site for a tracheal tube or tracheostomy tube to be inserted; this tube allows a person to breathe without the use of the nose or mouth.
There are four main indications for a tracheotomy.
1. Airway access for prolonged mechanical ventilation.
2. Decreased/incompetent clearance of tracheobronchial secretions.
3. Emergency airway access.
4. Functional or mechanical upper airway obstruction.
In the acute (short-term) setting, indications for tracheotomy include such conditions as severe facial trauma, tumors of the head and neck, and acute angioedema and inflammation of the head and neck. In the situation of failed tracheal intubation, either tracheotomy or cricothyrotomy may be performed.
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