Tracheostomy
A tracheostomy is a procedure that creates a small opening in the front of the neck directly into the windpipe (trachea), where a breathing tube is placed. It provides a secure airway when the upper airway is obstructed, when a patient needs long-term ventilator support, or when secretions must be cleared from the lungs.
Medically reviewed by the Florence Healthcare medical team · Last reviewed June 2026
Overview
Tracheostomy is performed by ENT or head-and-neck surgeons and intensive-care teams to provide a safe, stable airway below the level of the mouth and voice box. It is used when the upper airway is blocked by a tumor, swelling or trauma, when a patient requires prolonged mechanical ventilation, or when the airway needs regular clearing of secretions. The opening can be made surgically in an operating theatre or percutaneously at the bedside using a guidewire technique, depending on the situation. A tube holds the opening (stoma) open, and breathing, suctioning and — where appropriate — speaking-valve use are all possible through it.
Many tracheostomies are temporary and are removed (decannulated) once the underlying problem resolves and the patient can breathe and protect the airway normally. For international patients, particularly those needing head-and-neck cancer surgery or complex airway reconstruction, a coordinator arranges the consultation, imaging review and a transparent treatment and cost plan. Our specialists can review scans and records remotely beforehand, and the team provides detailed stoma-care training and an aftercare plan for safe travel home.
Who is a candidate?
- Patients with upper-airway obstruction from a tumor, severe swelling, infection or trauma
- People who need prolonged mechanical ventilation and would benefit from moving off a breathing tube in the mouth
- Patients who cannot clear secretions effectively and need regular airway suctioning
- Those undergoing major head, neck or throat surgery where the airway must be protected
- People with certain neurological or neuromuscular conditions affecting breathing or swallowing
- Patients assessed as fit for the procedure by the surgical and anesthesia teams
What happens
- 1
Assessment and planning
The surgical and critical-care teams review the airway, imaging and overall condition to decide between a surgical or bedside (percutaneous) approach and to plan the safest technique.
- 2
Preparation
The neck is positioned and cleaned, monitoring is applied, and anesthesia is given — usually general anesthesia, or local anesthetic with sedation for a bedside procedure.
- 3
Creating the airway
The surgeon makes a small opening in the front of the neck into the trachea and places a tracheostomy tube, confirming correct position and secure breathing before finishing.
- 4
Early care
The stoma and tube are monitored closely. Nurses and respiratory therapists manage suctioning and humidified air, and the first tube change is performed once the tract has begun to form.
- 5
Training and next steps
Patients and caregivers are taught stoma and tube care, suctioning and emergency steps. Speaking-valve use and swallowing are introduced when safe, and decannulation is planned if the airway recovers.
Benefits
- Secures a reliable airway when the mouth or throat route is blocked or unsafe
- Makes prolonged ventilator support more comfortable than a tube through the mouth
- Allows effective, regular clearing of secretions from the lower airway
- Can preserve speech and swallowing rehabilitation with speaking valves once stable
- Is frequently temporary and reversible once the underlying condition improves
Risks & considerations
- Bleeding around the stoma, most relevant in the early period after the procedure
- Infection of the stoma site or chest, which the team monitors and treats
- Tube blockage or displacement, which is why careful care and training are essential
- Narrowing (stenosis) of the windpipe over time in a minority of patients
- Temporary changes to voice and swallowing while the tube is in place
- The usual risks of anesthesia and of any underlying critical illness
Conditions this treats
Where it is performed
This procedure is performed by our Ear, Nose & Throat Department.
Learn more before you decide
Provider-reviewed guides on the related conditions, symptoms and tests in our Health Library.
Tracheostomy — frequently asked questions
Cost and stay depend heavily on the underlying condition — for example airway surgery for cancer versus support during critical illness. Because it is usually part of a wider treatment plan, your coordinator prepares a transparent, personalized estimate covering the procedure, the related care and the expected length of stay before you travel.
Yes. You can send scans, airway assessments and medical records for a remote review, so our ENT and head-and-neck specialists can advise whether a tracheostomy is needed, how it fits the overall plan, and what to expect.
Many patients can speak using a speaking valve or by covering the tube once they are stable and the team confirms it is safe. Speech and swallowing rehabilitation is a planned part of recovery.
Often it is temporary. When the airway obstruction or breathing problem resolves and you can protect your airway safely, the tube can be removed and the opening usually closes on its own.
Before discharge, you and your caregivers receive hands-on training in cleaning, suctioning, changing the tube and handling emergencies, plus a written aftercare plan and guidance for travelling home safely.
The procedure itself is done under anesthesia, so it is not felt. Afterwards there is some neck discomfort around the stoma, which is managed with simple pain relief and usually eases as healing progresses.
Related treatments
Considering tracheostomy?
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