Tracheotomy refers to the opening or incision made during a medical procedure to aid breathing, called a tracheostomy. Many people use these terms interchangeably.

When used as a synonym for tracheostomy, tracheotomy refers to a medical procedure where a surgeon or doctor makes an incision in the neck and then places a tube through the opening into the trachea.

The tubing may be temporary or permanent. Either way, it allows a person to breathe through the tube instead of their nose or mouth.

This article reviews what a tracheotomy is, its purpose, risks, preparation, and more.

A tracheotomy and tracheostomy are technically different from one another. Tracheotomy refers to the incision made into the throat during a tracheostomy, which is the actual term for the medical procedure.

However, as a 2022 article notes, most people use the terms interchangeably to refer to the procedure. In this article, tracheotomy refers to the surgical procedure.

Learn about tracheostomy procedures, including their uses and complications.

The main purpose of a tracheotomy is to create an opening in the trachea to aid breathing. The procedure allows the person to bypass the mouth and nose and breathe through an inserted tube.

Potential uses include to help:

  • wean a person from ventilation
  • facilitate mechanical ventilation
  • manage secretions
  • open the airways in an emergency when an obstruction blocks breathing
  • prepare for head and neck cancer treatment
  • obstructive sleep apnea
  • manage infections
  • manage airway burns

A tracheotomy is an invasive procedure where a doctor makes an incision and places a tube in the neck and trachea. Though generally safe when done in an operating room setting, it does carry some risks.

These can include:

  • bleeding during the procedure
  • missing the trachea
  • damage to the top of the lung
  • infection, though this is rare
  • obstruction to the tube from mucus or blood
  • tube dislodgement
  • possible failure of the opening
  • development of a fistula, an opening between different parts of the body

Preparation will depend on the nature of the tracheotomy. In an emergency, a doctor will need to perform the procedure without preparation.

In cases of scheduled tracheotomy, a doctor or hospital will provide the person with detailed instructions on how to prepare. Often preparation involves stopping any food and drink several hours beforehand due to the use of general anesthesia.

However, some forms of the procedure do not need general anesthesia. A doctor may perform them with a local numbing agent. These types of procedures may not require special preparation.

A person should review with their doctor when and if they should stop any medication. They should also make plans to stay in the hospital for a few days.

The majority of procedures involve using general anesthesia in an open surgery situation. Once ready, the surgeon will often:

  • make a vertical or horizontal incision around the midline of the neck, just below the larynx
  • work past muscles and other tissue in the neck to reach the trachea and make an incision through the outer rings on the structure
  • insert a tube into the trachea

To help hold the tube in place, they may add additional structures or a band around the neck. They may attach a ventilator to the tube to aid breathing.

In some cases, a doctor may perform the procedure using only local anesthesia, known as an awake tracheotomy or percutaneous tracheotomy.

A doctor may perform this procedure at a person’s bedside in a hospital setting. It is typically only when a surgical tracheotomy is not feasible or has failed.

In a 2018 study, researchers found that candidates for noncancer-related awake tracheotomy tended to be younger and had more complications.

However, a 2017 article noted that most percutaneous tracheostomies occur in the intensive care unit, where a person may already be under sedation. While some experts acknowledge the increased risk of complications with the technique, this study noted that it can:

  • have a favorable complication rate and lower infection rate
  • shorter procedural duration
  • be more cost-effective

The percutaneous tracheotomy procedure involves injecting local anesthesia into the neck. The doctor then uses a needle to insert a guide wire, which they use to guide the tube into the trachea. They may use imaging technologies, such as ultrasound, to help guide the procedure.

Following the procedure, a person will need to spend a few days in the hospital. The nurses and doctors will regularly check the incision and tubing for signs of infection and other issues. They will also likely clean the tubing and help ensure nothing blocks the airway.

It typically takes about 7 days for the opening to stabilize. At that point, a doctor can replace the initial tube with a smaller tube or a new tube. A surgical team typically performs the first exchange.

If released from the hospital, a person should follow all care instructions from their doctor. This may include keeping the tubing clean and watching for signs of infection.

A person should plan to attend any follow-up care appointments with a doctor. The doctor will likely check the opening and tubing, look for signs of infection, and help answer and address any issues that arise.

A tracheotomy can help open up the airways so a person can breathe or breathe better. Though complications can occur, experts generally believe it is a safe procedure.

According to a 2017 study, an experienced team, preplanning, and imaging technology can all aid outcomes.

A tracheotomy, also known as a tracheostomy, refers to a medical procedure where a doctor inserts a tube into the trachea. This may be to aid in breathing before another treatment, such as neck or head cancer, or in an emergency, such as an obstructive airway.

Though generally considered safe, a tracheotomy can cause complications ranging from bleeding and infection to more serious complications, such as fissures forming in the neck or damage to other structures.