“Tracheotomy To Life” “

 Tracheotomy (US /ˌtrkiˈɒtəmi/ tray-kee-aw-tə-mee) is a surgical procedure which consists of making an incision on the anterior aspect of the neck and opening a direct airway through an incision in the trachea (windpipe). The resulting stoma (hole), or tracheostomy, can serve independently as an airway or as a site for a tracheostomy tube to be inserted; this tube allows a person to breathe without the use of the nose or mouth. The tracheostomy tube is one type of tracheal tube.

What Is a Tracheostomy?

Highlights Tracheostomies are performed for many reasons related to a blocked airway or a need for prolonged respiratory or ventilator support.

During a tracheostomy, a tube is inserted into your windpipe to open the restricted airway and enable breathing. Tracheostomies are also known as stomas. This term refers to the hole in the neck that the tube is inserted through.

A tracheostomy is a medical procedure — either temporary or permanent — that involves creating an opening in the neck in order to place a tube into a person’s windpipe.

The tube is inserted through a cut in the neck below the vocal cords. This allows air to enter the lungs. Breathing is then done through the tube, bypassing the mouth, nose, and throat.

A tracheostomy is commonly referred to as a stoma. This is the name for the hole in the neck that the tube passes through.

Why a Tracheostomy Is Performed

A tracheostomy is performed for several reasons, all involving restricted airways. It may be done during an emergency when your airway is blocked. Or it could be used when a disease or other problem makes normal breathing impossible.

‘Many Conditions’ that may require a tracheostomy include:

  • anaphylaxis
  • birth defects of the airway
  • burns of the airway from inhalation of corrosive material
  • cancer in the neck
  • chronic lung disease
  • coma
  • diaphragm dysfunction
  • facial burns or surgery
  • infection
  • injury to the larynx or laryngectomy
  • injury to the chest wall
  • need for prolonged respiratory or ventilator support
  • obstruction of the airway by a foreign body
  • obstructive sleep apnea
  • paralysis of the muscles used in swallowing
  • severe neck or mouth injuries
  • Seizures

  • tumors
  • vocal cord paralysis

Prior to 16th century

Tracheotomy was first depicted on Egyptian artifacts in 3600 BC. It was described in the Rigveda, a Sanskrit text, circa 2000 BC.Homerus of Byzantium is said to have written of Alexander the Great saving a soldier from suffocation by making an incision with the tip of his sword in the man’s trachea. Hippocrates condemned the practice of tracheotomy as incurring an unacceptable risk of damage to the carotid artery. Warning against the possibility of death from inadvertent laceration of the carotid artery during tracheotomy, he instead advocated the practice of tracheal intubation. Because surgical instruments were not sterilized at that time, infections following surgery also produced numerous complications, including dyspnea, often leading to death.

Despite the concerns of Hippocrates, it is believed that an early tracheotomy was performed by Asclepiades of Bithynia, who lived in Rome around 100 BC. Galen and Aretaeus, both of whom lived in Rome in the 2nd century AD, credit Asclepiades as being the first physician to perform a non-emergency tracheotomy. Antyllus, another Roman physician of the 2nd century AD, supported tracheotomy when treating oral diseases. He refined the technique to be more similar to that used in modern times, recommending that a transverse incision be made between the third and fourth tracheal rings for the treatment of life-threatening airway obstruction.  Antyllus (whose original writings were lost but not before they were preserved by the Greek historian Oribasius) wrote that tracheotomy was not effective however in cases of severe laryngotracheobronchitis because the pathology was distal to the operative site. In AD 131, Galen clarified the anatomy of the trachea and was the first to demonstrate that the larynx generates the voice.

By AD 700, the tracheotomy was well described in Indian and Arabian literature, although it was rarely practiced on humans. In 1000, Abu al-Qasim al-Zahrawi (936–1013), an Arab who lived in Arabic Spain, published the 30-volume Kitab al-Tasrif, the first illustrated work on surgery. He never performed a tracheotomy, but he did treat a slave girl who had cut her own throat in a suicide attempt. Al-Zahrawi (known to Europeans as Albucasis) sewed up the wound and the girl recovered, thereby proving that an incision in the larynx could heal. Circa AD 1020, Avicenna (980–1037) described tracheal intubation in The Canon of Medicine in order to facilitate breathing.The first correct description of the tracheotomy operation for treatment of asphyxiation was described by Ibn Zuhr (1091–1161) in the 12th century. According to Mostafa Shehata, Ibn Zuhr (also known as Avenzoar) successfully practiced the tracheotomy procedure on a goat, justifying Galen’s approval of the operation.

16th–18th centuries

The European Renaissance brought with it significant advances in all scientific fields, particularly surgery. Increased knowledge of anatomy was a major factor in these developments. Surgeons became increasingly open to experimental surgery on the trachea. During this period, many surgeons attempted to perform tracheotomies, for various reasons and with various methods. Many suggestions were put forward, but little actual progress was made toward making the procedure more successful. The tracheotomy remained a dangerous operation with a very low success rate, quantify and many surgeons still considered the tracheotomy to be a useless and dangerous procedure. The high mortality rate quantify for this operation, which had not improved, supports their position.

From the period 1500 to 1832 there are only 28 known reports of tracheotomy.  In 1543, Andreas Vesalius (1514–1564) wrote that tracheal intubation and subsequent artificial respiration could be life-saving. Antonio Musa Brassavola (1490–1554) of Ferrara treated a patient suffering from peritonsillar abscess by tracheotomy after the patient had been refused by barber surgeons. The patient apparently made a complete recovery, and Brassavola published his account in 1546. This operation has been identified as the first recorded successful tracheostomy, despite many ancient references to the trachea and possibly to its opening.  Ambroise Paré (1510–1590) described suture of tracheal lacerations in the mid-16th century. One patient survived despite a concomitant injury to the internal jugular vein. Another sustained wounds to the trachea and esophagus and died.

Hieronymus Fabricius

Towards the end of the 16th century, anatomist and surgeon Hieronymus Fabricius (1533–1619) described a useful technique for tracheotomy in his writings, although he had never actually performed the operation himself. He advised using a vertical incision and was the first to introduce the idea of a tracheostomy tube. This was a straight, short cannulae that incorporated wings to prevent the tube from advancing too far into the trachea. He recommended the operation only as a last resort, to be used in cases of airway obstruction by foreign bodies or secretions. He counseled that the operation should be performed only as a last option. Fabricius’ description of the tracheotomy procedure is similar to that used today. Julius Casserius (1561–1616)

Giulio_Casserio._Line_engraving,_1688._Wellcome_V0001025.jpg

succeeded Fabricius as professor of anatomy at the University of Padua and published his own writings regarding technique and equipment for tracheotomy. Casserius recommended using a curved silver tube with several holes in it. Marco Aurelio Severino (1580–1656),

300px-M_A_Severino.png

a skillful surgeon and anatomist, performed multiple successful tracheotomies during a diphtheria epidemic in Naples in 1610, using the vertical incision technique recommended by Fabricius. He also developed his own version of a trocar.

In 1620 the French surgeon Nicholas Habicot (1550–1624), surgeon of the Duke of Nemours and anatomist, published a report of four successful “bronchotomies” which he had performed.One of these is the first recorded case of a tracheotomy for the removal of a foreign body, in this instance a blood clot in the larynx of a stabbing victim. He also described the first tracheotomy to be performed on a patricide patient. A 14-year-old boy swallowed a bag containing 9 gold coins in an attempt to prevent its theft by a highwayman. The object became lodged in his esophagus, obstructing his trachea. Habicot performed a tracheotomy, which allowed him to manipulate the bag so that it passed through the boy’s alimentary tract, apparently with no further sequelae. Habicot suggested that the operation might also be effective for patients suffering from inflammation of the larynx. He developed equipment for this surgical procedure which displayed similarities to modern designs (except for his use of a single-tube cannula).

Sanctorius (1561–1636) is believed to be the first to use a trocar in the operation, and he recommended leaving the cannula in place for a few days following the operation. Early tracheostomy devices are illustrated in Habicot’s Question Chirurgicale  and Julius Casserius’ posthumous Tabulae anatomicae in 1627. Thomas Fienus (1567–1631), Professor of Medicine at the University of Louvain, was the first to use the word “tracheotomy” in 1649, but this term was not commonly used until a century later. Georg Detharding (1671–1747), professor of anatomy at the University of Rostock, treated a drowning victim with tracheostomy in 1714.

The practice of gastric endoscopy in humans was pioneered by United States Army surgeon William Beaumont (1785–1853) in 1822 with the cooperation of his patient Alexis St. Martin (1794–1880), a victim of an accidental gunshot wound to the stomach. In 1853, Antonin Jean Desormeaux (1815–1882) of Paris modified Bozzini’s lichtleiter such that a mirror would reflect light from a kerosene lamp through a long metal channel. Referring to this instrument as an endoscope (he is credited with coining this term), Desormeaux employed it to examine the urinary bladder. However, like Bozzini’s lichtleiter, Desormeaux’s endoscope was of limited utility due to its propensity to become very hot during use. In 1868, Adolph Kussmaul (1822–1902) of Germany performed the first esophagogastroduodenoscopy (a diagnostic procedure in which an endoscope is used to visualize the esophagus, stomach and duodenum) on a living human.

19th century

In the 1820s, the tracheotomy began to be recognized as a legitimate means of treating severe airway obstruction. In 1832, French physician Pierre Bretonneau employed it as a last resort to treat a case of diphtheria. In 1852, Bretonneau’s student Armand Trousseau reported a series of 169 tracheotomies (158 of which were for croup, and 11 for “chronic maladies of the larynx”)  In 1858, John Snow was the first to report tracheotomy and cannulation of the trachea for the administration of chloroform anesthesia in an animal model.  In 1871, the German surgeon Friedrich Trendelenburg (1844–1924) published a paper describing the first successful elective human tracheotomy to be performed for the purpose of administration of general anesthesia.  In 1880, the Scottish surgeon William Macewen (1848–1924) reported on his use of orotracheal intubation as an alternative to tracheotomy to allow a patient with glottic edema to breathe, as well as in the setting of general anesthesia with chloroform. At last, in 1880 Morrell Mackenzie’s book discussed the symptoms indicating a tracheotomy and when the operation is absolutely necessary.

20th century

In the early 20th century, physicians began to use the tracheotomy in the treatment of patients afflicted with paralytic poliomyelitis who required mechanical ventilation. However, surgeons continued to debate various aspects of the tracheotomy well into the 20th century. Many techniques were described and employed, along with many different surgical instruments and tracheal tubes. Surgeons could not seem to reach a consensus on where or how the tracheal incision should be made, arguing whether the “high tracheotomy” or the “low tracheotomy” was more beneficial. The currently used surgical tracheotomy technique was described in 1909 by Chevalier Jackson of Pittsburgh, Pennsylvania. Jackson emphasised the importance of postoperative care, which dramatically reduced the death rate. By 1965, the surgical anatomy was thoroughly and widely understood, antibiotics were widely available and useful for treating postoperative infections, and other major complications had also become more manageable.

Why you say is Susan writting about this? Here it is. I myself have a tracheal tube. I have known many people have had the same proceedure done. It is not a easy road. You die or you survive. If God did not create us! Why on earth would he make a way for a person to live? Think about this! People still make in front of this proceedure or they blame it on one substance, not many diseases. Instead of being grateful for what God has done for humanity, others make in front of this proceedure. My lung was punctured! Because I had a seizure many years ago. The people at the hospital kept me alive. Hello!!! The insurance company refuses my chest x-rays. Why? They don’t have no clue. I had my lung punctured a preexisting condition, I can’t breathe through my mouth and nose. But I am alive. Praise God. I can do anything anyone else can do. So when people get upset with me thinking I am upset. They need to hold their nose and try to talk a while. Step into my shoes. He He.   But the Insurance Co changed their rules, laws, amendment, whatever they call this,  because the hospital kept me alive. Can I fight this insurance company for not letting me have any more x-rays. No! It has been years like 4 or 5 since my last x-ray. So Methodist hospital of Houston really saved my life Michael Stewart, Rance Raney and Ather Sidiqi many other caring physicians. They said I shouldn’t of been here. I am. I am Very  Thankful for them and God for my life.  It says in the bible: get mad but don’t sin in your madness!!! Well it is not all about me. You don’t put new food in a dirty refrigerator. Just saying! I knew this lady a few years ago. She showed up at a “Home” (no names) This lady was on medicaid. She had a tracheal tube. The “INSURANCE” wouldn’t pay for supplys for her. She was hurt bad and needed a suction machine when she came to this said; home. Anyways she left. There are many people out there that our government don’t know the half of what their people are going through. My brother in the past months has lost one leg under the knee and the right one over the knee and is unable to get government assistance. It is hard to realize the the government lets people die everyday. Because they are being neglected by the system. Just saying. Who is going to help these people no one see’s! Just saying.

“Tobacco Companies bashing people with tracheal tubes”

“I don’t see Tabasco in these situations”

 

  • anaphylaxis
  • birth defects of the airway
  • burns of the airway from inhalation of corrosive material
  • cancer in the neck
  • chronic lung disease
  • coma
  • diaphragm dysfunction
  • facial burns or surgery
  • infection
  • injury to the larynx or laryngectomy
  • injury to the chest wall”
  • Endoscopic view of tracheal stenosis after treatment with balloon dilation.
  • tracheal-stenosis-balloon-treatment-canonical
  • need for prolonged respiratory or ventilator support
  • obstruction of the airway by a foreign body
  • obstructive sleep apnea
  • paralysis of the muscles used in swallowing
  • severe neck or mouth injuries
  • Seizures

  • 12779267_1575086276137824_5617276705560384887_o
  • tumors
  • vocal cord paralysis
  • Now I will be quiet!!!
  • I have met several people who have had different medical happenings that proceeded in “Trac-heal tubes”   Get it Trac Heal! Oh! These people have survived.

    Testimonial of God’s Goodness!!

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s