A tracheostomy is a surgical procedure that creates an opening in the windpipe (trachea) in the neck. It is usually performed when an obstruction in the throat prevents proper breathing. Tracheostomies are used to provide an airway in several medical conditions that block the passage of air, including oral or throat cancers or cancers that may have spread to this area.

During a tracheostomy, an incision is made in the windpipe (trachea). The opening made in the trachea is also known as a stoma. A stoma is any opening in the body made surgically to replace a normal opening, (e.g., colostomy).

After the stoma has been created, a plastic or metal tube is inserted through the hole into the trachea. This bypasses the blocked air passage in the trachea or throat and allows air to pass into and out of the lungs. 

After a tracheostomy is performed, individuals no longer breathe through their mouth or nose. Air is exchanged directly from outside the body into the lungs through the stoma. For this reason, the air is not filtered or warmed by the nose or mouth before entering the lungs. In addition, secretions produced by the lungs and bronchi may collect in the trachea. If the secretions cannot be cleared from the stoma by the patient’s coughing, they will need to be suctioned intermittently as needed. This is typically done with small tubing connected to an external suction machine. The secretions must be removed as they can block the patient’s ability to breathe. 

This tracheostomy tube inserted into the patient is composed of three sections:

• Outer cannula. The outer tube that holds the tracheostomy open. A neck plate extends from the sides of the outer tube with two holes. Cloth ties or a velcro strap can be attached to holes in the outer tube, allowing it to be worn secured around the neck.
  
  
• Inner cannula. Fits inside the outer cannula and has a lock to prevent it from being pushed or coughed out. This part of the tracheostomy tube can be removed for cleaning, especially in the morning and at bedtime. It is necessary to keep the inner cannula clean and fere from secretions or debris to facilitate breathing.
  
  
• Obturator. Fits inside the tracheostomy tube and provides a smooth surface that guides the tracheotomy tube during insertion.

Tracheostomies are used in many medical conditions other than cancer. These include:

• Inherited abnormalities of the larynx or trachea
• Severe neck or mouth injuries
• Noncancerous (benign) objects that block the airway
• Paralysis or weakness of muscles that affect breathing and swallowing
• Long-term unconsciousness or coma