Perioperative management - Plastic Tracheotomy

• Long-term ventilation for more than 21 days
• Airway obstruction; for example, due to injuries or tumors
• The advantages over translaryngeal intubation:– avoidance of damage to the arytenoid cartilages
  – avoidance of mucosal lesions on the vocal cords, trachea, as well as in the mouth and nose
  – reduced airway resistance (decreased work of breathing)
  – reduced dead space
  – better fixation capability
  – improved oral care
  – reduced need for analgesics and sedatives
  – higher patient comfort (speaking and oral intake of food are possible, foreign body sensation is absent)
  – weaning from the ventilator is facilitated or even made possible

• Infections in the area of the incision site
• Unstable cervical spine
• Blood coagulation disorders
• Severe gas exchange disorders

• Determination of blood coagulation parameters
• Bronchoscopy

None

• Bleeding
• Infection
• Injury to the trachea
• Possibility of necessary surgical revision
• Pneumothorax
• Injury to the recurrent nerve
• Subcutaneous emphysema/mediastinal emphysema
• Scar formation at the tracheostoma
• Cardiac arrest due to vagus nerve stimulation