Tracheostomy 101

An easy-to-understand guide to ENT and tracheostomy, including its history, purpose, procedure, and daily care tips.

What is ENT?

ENT stands for Ear, Nose, and Throat. Doctors working in this area are ENT specialists or otolaryngologists (say it like: oh-toe-lair-in-goll-oh-jists). These doctors treat problems with your ears, nose, and throat.

A quick look at tracheostomy history

Tracheostomy is not something new—people have been using similar methods to help others breathe for thousands of years.

3600 BC: Ancient Egyptian drawings show one of the earliest examples of a tracheostomy.

There's a famous story that Alexander the Great once saved a choking soldier. He used his sword to make a hole in the soldier’s neck so he could breathe.

In 1546, a doctor named Antonio Musa Brasavola performed the first successful tracheostomy surgery that was written down in history. For many years after that, tracheostomies were rarely done because they were risky and hard to perform safely.

By the early 1900s, doctors learned how to do the surgery more safely. One important figure was Dr. Chevalier Jackson, who made big improvements to the procedure. Later, during the polio outbreak, tracheostomies became more common because they helped patients who had trouble breathing.

What is a tracheostomy?

A tracheostomy (say it like: tray-key-OS-tuh-me) is a surgery where doctors make a small hole in the neck and into the windpipe (also called the trachea). This hole helps air get into the lungs when someone can’t breathe well through their nose or mouth.

Tracheotomy vs. tracheostomy – what’s the difference?

A tracheotomy is the cut the doctor makes.
A tracheostomy is the hole that is made.
People sometimes use these two words to mean the same thing, and that’s okay.

Why do people need a tracheostomy?

You might need a tracheostomy if:

1. You’re using a breathing machine (ventilator) for a long time.

2. Something is blocking your airway (like swelling or a tumor).

3. You have a lot of mucus that makes breathing hard.

4. You have an emergency and can’t breathe.

What is a tracheostomy tube?

After the hole is made in your neck, doctors put in a small tube. This tube helps air go in and out of your lungs. Some tubes have a small balloon (called a cuff), and some don’t. Different kinds are available depending on what you need.

Signs that someone may need a tracheostomy

1. They can’t breathe on their own.

2. They still need a ventilator after a long time.

3. They have something blocking their airway.

4. They have lots of mucus they can’t cough out.

Things to stay away from if you have a tracheostomy

To keep your airway clean and safe, try to avoid:

1. Dust

2. Tiny food crumbs

3. Smoke

4. Powder (like baby powder or makeup)

5. Spray cans (like air freshener or hairspray)

How to eat safely with a tracheostomy

Here are some tips if you or someone you know eats with a tracheostomy:

1. Listen to your doctor or therapist about what foods are safe.

2. If you have a cuffed tube, ask if it should be deflated before eating.

3. You may need to suction your airway before meals to stay safe.

4. Drink plenty of water – it helps keep mucus thin and easier to clear.

5. Eat high-fiber foods like fruits, veggies, beans, and whole grains to help with digestion.

6. Sit up straight, take small bites, chew well, and eat slowly.

Final thoughts

A tracheostomy can help people who have trouble breathing. It’s a safe and helpful way to make sure air can get into the lungs. With the right care, people with a tracheostomy can live well and stay healthy.

References

Bhatti, Nasir. “Tracheostomy.” Johns Hopkins Medicine, 7 Feb. 2023. www.hopkinsmedicine.org

Cheung, N. H., and L. M. Napolitano. “Tracheostomy: Epidemiology, Indications, Timing, Technique, and Outcomes.” Respiratory Care, vol. 59, no. 6, June 2014, pp. 895–919. DOI link