10.19\ Tracheotomy

10.19.1  Discussion

Tracheotomy is performed in order to secure the airway and consists of creating an opening between the skin and trachea, or tracheostomy, via open surgical or bronchoscopic techniques. Once the passage is created and dilated, a tracheostomy tube is inserted. There are various types of tracheotomy tubes, but these commonly consist of an obturator, curved inner and outer can-

a

nulas, and an inflatable cuff. CT with multiplanar reconstructions and volume renderings, such as tissue transition projection, is a suitable method for evaluating position of tube in relation to tracheal wall (Fig. 10.97), tracheal stenosis, and various complications. Early complications related to tracheotomy and tracheostomy tubes include hemorrhage, infection, tube obstruction, and placement into a false tract (Fig. 10.98), while late complications include tracheomalacia, tracheoesophageal fistula, tracheoinnominate artery erosion, and tracheal stenosis (Fig. 10.99).

b

Fig. 10.97  Tracheostomy tube. Sagittal CT image (a) shows a tracheostomy tube in position for upper airway stenosis. The corresponding frontal tissue transition pro-

jection CT image (b) demonstrated the narrowing of the airway superior to the tracheostomy tube (arrow) to better advantage