January 3, 2022

When you need a tracheostomy or a stoma

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A “trach” or a stoma allows air to reach your lungs. But they require care to avoid problems.

A tracheostomy gives you a new pathway for air to go into and out of your lungs. This pathway is created with a surgery, to make a small opening in the front of your neck, into your trachea (the windpipe). A tracheostomy tube (also called a trach tube) is placed in this opening. It lets air flow from outside into your windpipe to your lungs. When you exhale, the air flows back out of the trach tube.

Common reasons for a tracheostomy tube

  • Scarring of the larynx or trachea, for example from prolonged intubation
  • Trauma to the larynx or trachea
  • Throat swelling that blocks the airway, such as from an allergic reaction
  • Throat damage, such as a burn
  • An object or growth, such as a tumor, that blocks the throat or trachea
  • Respiratory failure and the need for extra oxygen, such as with severe emphysema
  • Sleep apnea 
  • Paralysis in the belly, chest, neck or throat that affects breathing
  • Surgery on the larynx
  • Cancer in or near the trachea
  • Need for long-term breathing help with a ventilator

If you have a temporary tracheostomy tube 

Your tracheostomy tube has been chosen to fit well and work right for you. You’ll learn how to keep it clean and clear. Often, a trach tube is needed only a short time. Your surgeon will tell you how long you will need to to use a trach tube.

If you don’t need a new airway after surgery, the hole in the front of your throat will close on its own after the trach tube has been removed. You will have a dressing over the site while it heals. In some cases, surgery is needed to close the hole.

If you have a permanent tracheostomy (stoma)

If your larynx was removed during surgery, you’ll continue to breathe through the hole in your throat. This hole is called a stoma or permanent tracheostomy.

It’s important that you and those who care for you understand that this is your only airway. In a medical emergency, health care providers won’t be able to put in a breathing tube through your nose or mouth. 

You’ll be shown how to care for your stoma. Support groups can help you adjust to having a new airway. And you can return to work, family life and many of the activities you enjoyed before surgery. You will need follow-up visits for your tracheostomy or stoma, and its care.

Vanderbilt Health’s specialists in the Complex Airway Reconstruction Program have the expertise to accurately evaluate, diagnose and treat a wide array of complex airway disorders. Our comprehensive team works with you to develop a personalized care plan, so you can swallow, speak and breathe with ease. Call 615-343-0540 for more information.

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