A tracheostomy, or trach, is a stoma (hole) created in the skin of the front of the neck and connected to the trachea (windpipe). It is performed to assist a person in breathing. If the doctor anticipates significant swelling in the airway after cancer removal, he or she may do a short-term tracheotomy (using a thin plastic tube) to enable the patient to breathe more comfortably until the swelling subsides. It remains in place for a brief period of time before being withdrawn (or reversed) when no longer required.
Tracheal stenosis treatment enlarges the airway, making breathing easier. Bronchscopy is done in the operating room while the patient is sleeping. Occasionally, a laser is utilized to constrict the airway from the inside. The airway is subsequently expanded with a high pressure balloon dilator. To avoid the production of scars, steroids and other drugs are used. The whole treatment is carried out orally. When balloon dilation is insufficient, open resection is an option. On the neck, a skin incision is done and the stenotic airway is excised. Following that, the regular airway is reattached and sutured together.
Paralytics are drugs that cause full muscular relaxation and aid intubation and surgery. These medications are only given to individuals who are fully unconscious and in a controlled environment. Succinylcholine is a short-acting paralytic that is often used for minor operations that do not need intubation or in crisis circumstances. Vecuronium, rocuronium (Zemuron®), and cisatracurium (Nimbex®) are all long-acting paralytics that are used to sustain paralysis during prolonged surgical operations. Prior to terminating anesthesia and removing the breathing tube at the completion of operation, reversal medications are administered to reverse the muscle relaxation effects.
Noninvasive Mechanical Ventilation. Bach, John R. Hanley and Belfus, New Jersey, 2002. Johannes J. Fagan et al. Tracheotomy. American Academy of Otolaryngology-Head & Neck Surgery Foundation, Inc., Alexandria, VA, 1997. "Neck Surgery." In Robert M. Younson, ed., The Surgery Book: An Illustrated Guide to 73 of the Most Common Operations. St. Martin's Press, New York, 1993. Nancy V. Schantz. "Emergency Cricothyroidotomy and Tracheostomy." In John Pfenninger and Grant Fowler's Procedures for the Primary Care Physician. Mosby, New York, 1994. other "Frequently Asked Questions About Otolaryngology Health Care." Head and Neck Surgery Page of the Department of Otolaryngology. [cited July 1, 2003] University of Washington School of Medicine. Weber, University of Washington, http://weber.u.washington.edu/otoweb/trach.html "Tracheotomy Complications." Sicard, Michael W. Otorhinolaryngology and Communicative Sciences Department of Bobby R. Alford 1 December 1994 [retrieved 1 July 2003]. Visit http://www.bcm.tmc.edu/oto/grand/12194.html for further information.
