tracheotomy

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tracheotomy

(trākēŏt`əmē), surgical incision into the trachea, or windpipe. The operation is performed when the windpipe has become blocked, e.g., by the presence of some foreign object or by swelling of the larynx. A curved or flexible tube is inserted into the trachea to facilitate breathing. In diseases such as pneumonia that cause the lungs to fill with fluids, this same incision may be used to drain the lungs. A tracheostomy is the surgical formation of a rounded opening into the trachea and differs from a tracheotomy in that the former procedure establishes a permanent opening.

Tracheotomy

 

an emergency operation performed in cases of arrested breathing; a resuscitation technique. The operation was known to the ancient Greek physicians Asclepiades and Galen and has been performed regularly since the 16th century.

Tracheotomy permits the free passage of air into the respiratory tract when the trachea is obstructed as a result of an inflammatory swelling, tumor, spasm of the vocal cords, injury, or foreign body. The incision is made below the obstruction. Modern indications for tracheotomy have been broadened to include cases of respiratory disturbances when the respiratory tract is unobstructed. Such cases include unconsciousness accompanied by the loss of the coughing and breathing reflexes, impairment of the respiratory mechanism after a chest injury, and pulmonary edema.

In tracheotomy, the trachea is generally incised longitudinally or transversely above (superior tracheotomy) or below (inferior tracheotomy) the isthmus of the thyroid. When an emergency tracheotomy is performed at the site of an accident, any available instrument, such as a penknife, may be used. A double tube made of high-grade metal or plastic is inserted into the incision. The inside tube is periodically removed and replaced, or cleansed and sterilized. The upper respiratory tract is cleansed through a tracheostoma, or opening in the trachea. Through this opening, mucus is removed by suction, the trachea is irrigated, and medicine is administered. Artificial respiration is carried out through the tracheostoma as well. After breathing is restored, the tube inserted in the tracheostoma is removed. The opening in the trachea usually heals without complications.

REFERENCE

Arapov, D. A., and Iu. V. Isakov. Trakheostomiia v sovremennoi klinike, 2nd ed. Moscow, 1974.
E. G. DEKHTIAR

tracheotomy

surgical incision into the trachea, usually performed when the upper air passage has been blocked
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