Complications

Every operation, however small, has complications. Bleeding or injury to surrounding structures are usually the most common complications. This is also the case with tracheotomy.

Surrounding structures/organs here are the thyroid gland, certain nerves and vessels. If the patient has a particularly large thyroid gland, it may be necessary to remove part of it. In addition, the thyroid gland is an organ with a good blood supply, so injuries to this bleeding can result.

If nerves are injured, this can lead to numbness or paralysis of the vocal cords, which in turn can lead to a constantly hoarse voice. In the worst case, when the nerves on both sides are severed, vocal cord paralysis occurs, causing breathing difficulties because the vocal cords close the trachea opening when paralyzed. In addition then speaking is no longer possible.

If the vessels are injured, there may be bleeding during the operation, but also secondary bleeding. In addition, the tube can slip or slip out if it is not sutured tightly. If the tube is pressed against the tissue, swelling, infection, scarring and wound healing can occur.

Speaking is actually not possible with a tube, but if the patient needs a tube for a longer period of time, a so-called speech cannula can be inserted to make speaking possible again. Other disadvantages are that the patient can no longer smell, so the sense of taste is also disturbed. Advantages of the tracheotomy in contrast to the introduction of a breathing tube through the mouth are that the patient can eat, oral hygiene is possible and speaking with a speech cannula can also be made possible.

Risks

After a tracheotomy, the air no longer reaches the lungs via the mouth and nose, but via the applied ventilation cannula. The air flowing in through the nose normally humidifies the nose and thus ensures that the patient can smell. Therefore, people with a tracheotomy can no longer smell.

Since the tracheotomy is placed below the larynx, which is responsible for speaking, the patient can only speak by means of a special speaking valve. In addition to these disadvantages, the operation also carries certain risks such as bleeding or infection of the tracheotomy and the inserted cannula. But also important nerves can be damaged, especially the recurrent nerve (Nervus laryngeus recurrens), which supplies the larynx and is important for speaking.

However, damage to adjacent organs such as the thyroid gland or the esophagus is also possible. A narrowing of the trachea (tracheal stenosis) due to infections, mucus plugs or tissue formation is a life-threatening complication. In this case, a new operation is necessary to ensure that the patient can continue to be ventilated.