--- title: "Tracheostomy - Definition, Indications, Contraindications & Types" description: "ENT notes on Tracheostomy - Definition, Indications, Contraindications, Types, Advantages, Disadvantages and Functions." source: "The ENT Resident" author: "Dr. Mausumi Das" canonical_url: "https://www.theentresident.com/ent-notes-lectures/tracheostomy-definition-types-indications-contraindications" categories: ["Surgery", "Larynx and Trachea"] video: "https://www.youtube.com/watch?v=0gYn2uswAu0" image: "https://media.theentresident.com/og-images/tracheostomy-definition-types-indications-contraindications.png" --- # Tracheostomy - Definition, Indications, Contraindications & Types ENT notes on Tracheostomy - Definition, Indications, Contraindications, Types, Advantages, Disadvantages and Functions. Watch the full video lecture on YouTube: https://www.youtube.com/watch?v=0gYn2uswAu0 ## 🫁 Tracheostomy - Definition, Types, Indications, Contraindications & Functions **Tracheostomy** is a very important **ENT surgical procedure** and a **frequently asked viva topic**. In this article we will cover: - Difference between **Tracheotomy vs Tracheostomy** - Functions of tracheostomy - Physiological changes - Indications - Contraindications - Types of tracheostomy - Advantages and disadvantages --- ### 🔪 Tracheotomy vs Tracheostomy #### ✅ **Tracheotomy** - Making a surgical opening in the trachea - It is **one step of the tracheostomy procedure** #### ✅ **Tracheostomy** - A **surgical procedure in which a stoma is created on the skin** - This stoma communicates with the **tracheal lumen** > 👉 Therefore: **Tracheotomy = Opening in trachea** **Tracheostomy = Formation of permanent/temporary airway stoma** --- ### ⚙️ Functions of Tracheostomy **1- Relief of Upper Airway Obstruction** - Bypasses obstruction at **larynx / pharynx / upper trachea** **2- Reduction of Respiratory Dead Space** > What is normal dead space? > What is the % reduction seen in dead space in Tracheostomy? **3- Reduction in Airway Resistance** **4- Protection Against Aspiration** - Prevents aspiration of **blood / secretions** > What are some cases in which Tracheostomy is done to prevent aspiration? **5- Tracheobronchial Toileting** - Easy suction of secretions - Improves gas exchange **6- Route for Ventilation & Drug Delivery** >What are the Physiological Effects of Tracheostomy? --- ### 🚨 Indications of Tracheostomy #### 📌 A. Based on Cause **1️⃣ Respiratory Obstruction** - Infective causes - Traumatic causes - Neoplastic causes - Congenital causes - Others (Laryngeal edema, Foreign body larynx) > Name some infective indications of Tracheostomy. > Name some traumatic indications of Tracheostomy. > Name some congenital indications of Tracheostomy. > Name some neoplastic indications of Tracheostomy. **2️⃣ Retained Secretions** - Due to inability to cough - Painful cough - Aspiration of secretions > Name some causes where retained secretions is the indication for performing Tracheostomy. **3️⃣ Respiratory Insufficiency** - Chronic bronchitis - Emphysema - Bronchiectasis **4️⃣ Need for Prolonged Ventilation** - Intubation > **3 weeks** > What are the advantages of performing Tracheostomy over intubation in a patient who needs prolonged ventilation? **5️⃣ As Part of Surgical Procedure** - **Permanent:** Total laryngectomy - **Temporary:** Major oral / oropharyngeal resections --- #### 📌 B. Based on Site of Obstruction - Nose / Nasopharynx → Choanal atresia - Tongue base → Macroglossia - Supraglottis → Epiglottitis - Glottis → Vocal cord palsy - Subglottis → Stenosis / hemangioma - Trachea → Tracheomalacia / stenosis --- #### 📌 C. Indications in Infants & Children Infants → Mostly congenital Children → Mostly inflammatory / traumatic > What are some indications of Tracheostomy in infants and in children? --- ### ⛔ Contraindications of Tracheostomy 👉 **No absolute contraindication in emergency** #### Relative Contraindications - Bleeding disorders - Unstable cervical spine injury - Local infection at incision site > 📚 To know the complete list of Relative Contraindications of Tracheostomy, please purchase my notes. --- ### 📚 Types of Tracheostomy #### 🔹 Based on Timing - Elective - Emergency > What are the 2 types of Elective Tracheostomy? >What is Emergency Tracheostomy? #### 🔹 Based on Duration - Temporary - Permanent > What is Permanent Tracheostomy? Name some indications of Permanent Tracheostomy. #### 🔹 Based on Site - High Tracheostomy - Mid Tracheostomy ⭐ **(Most common)** - Low Tracheostomy > What is High Tracheostomy? What is the tracheal level at which it is done? > Name an indication of High Tracheostomy. > What is the complication of doing High Tracheostomy? > What is Mid Tracheostomy? What is the tracheal level at which it is done? > What is Low Tracheostomy? What is the tracheal level at which it is done? > What is the complication of doing Low Tracheostomy? --- ### ⭐ Advantages of Tracheostomy over Endotracheal Intubation - Can be maintained long term - Reduced dead space > 📚 To know the complete list of Advantages of Tracheostomy, please purchase my notes. --- ### ⚠️ Disadvantages of Tracheostomy - Surgical procedure → Time consuming - Risk of infection - Difficult decannulation - Loss of phonation > 📚 To know the complete list of Disadvantages of Tracheostomy, please purchase my notes. > What is difficult decannulation? What are some causes of difficult decannulation? --- ### 🧠 Exam Pearls - Dead space reduction → **30–50%** - Most common site → **Mid tracheostomy** - No absolute contraindication in emergency - High tracheostomy → **Only for carcinoma larynx** --- Next topic: ➡️ **Steps of Tracheostomy & Post-operative Care** --- ## About This Note This free ENT note on Tracheostomy - Definition, Indications, Contraindications & Types was written by Dr. Mausumi Das and is paired with a corresponding video lecture. Canonical page of this note: https://www.theentresident.com/ent-notes-lectures/tracheostomy-definition-types-indications-contraindications When citing or referencing this content, please credit The ENT Resident and link to the canonical page above. ## Related Notes by Category - Surgery: https://www.theentresident.com/ent-notes-lectures/category/surgery.md - Larynx and Trachea: https://www.theentresident.com/ent-notes-lectures/category/larynx-and-trachea.md ## About The ENT Resident The ENT Resident is an educational website and resource library created by Dr. Mausumi Das (MS ENT) for ENT residents, ENT postgraduates preparing for exams, and MBBS students. Dr. Mausumi Das writes the notes, draws the diagrams, and records the lectures herself. Browse all ENT notes and lectures on The ENT Resident: https://www.theentresident.com/ent-notes-lectures.md ## Medical-use Boundary The ENT Resident provides educational material for medical learning and revision. 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