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class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Indications</span> </div> </a> <ul id="toc-Indications-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Alternatives" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Alternatives"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Alternatives</span> </div> </a> <ul id="toc-Alternatives-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Components" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Components"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Components</span> </div> </a> <ul id="toc-Components-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Surgical_procedure" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Surgical_procedure"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Surgical procedure</span> </div> </a> <button aria-controls="toc-Surgical_procedure-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Surgical procedure subsection</span> </button> <ul id="toc-Surgical_procedure-sublist" class="vector-toc-list"> <li id="toc-Open_surgical_tracheotomy_(OST)" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Open_surgical_tracheotomy_(OST)"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.1</span> <span>Open surgical tracheotomy (OST)</span> </div> </a> <ul id="toc-Open_surgical_tracheotomy_(OST)-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Percutaneous_dilatational_tracheotomy_(PDT)" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Percutaneous_dilatational_tracheotomy_(PDT)"> <div class="vector-toc-text"> <span class="vector-toc-numb">5.2</span> <span>Percutaneous dilatational tracheotomy (PDT)</span> </div> </a> <ul id="toc-Percutaneous_dilatational_tracheotomy_(PDT)-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Risks_and_complications" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Risks_and_complications"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Risks and complications</span> </div> </a> <ul id="toc-Risks_and_complications-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>History</span> </div> </a> <button aria-controls="toc-History-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle History subsection</span> </button> <ul id="toc-History-sublist" class="vector-toc-list"> <li id="toc-Ancient_history" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Ancient_history"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.1</span> <span>Ancient history</span> </div> </a> <ul id="toc-Ancient_history-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Medieval_world" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Medieval_world"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.2</span> <span>Medieval world</span> </div> </a> <ul id="toc-Medieval_world-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-16th–18th_centuries" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#16th–18th_centuries"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.3</span> <span>16th–18th centuries</span> </div> </a> <ul id="toc-16th–18th_centuries-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-19th_century" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#19th_century"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.4</span> <span>19th century</span> </div> </a> <ul id="toc-19th_century-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-20th_century" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#20th_century"> <div class="vector-toc-text"> <span class="vector-toc-numb">7.5</span> <span>20th century</span> </div> </a> <ul id="toc-20th_century-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Society_and_culture" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Society_and_culture"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Society and culture</span> </div> </a> <ul id="toc-Society_and_culture-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Tracheotomy</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 38 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-38" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">38 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-af mw-list-item"><a href="https://af.wikipedia.org/wiki/Trageotomie" title="Trageotomie – Afrikaans" lang="af" hreflang="af" data-title="Trageotomie" data-language-autonym="Afrikaans" data-language-local-name="Afrikaans" class="interlanguage-link-target"><span>Afrikaans</span></a></li><li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%AB%D9%82%D8%A8_%D8%A7%D9%84%D9%82%D8%B5%D8%A8%D8%A9_%D8%A7%D9%84%D9%87%D9%88%D8%A7%D8%A6%D9%8A%D8%A9" title="ثقب القصبة الهوائية – Arabic" lang="ar" hreflang="ar" data-title="ثقب القصبة الهوائية" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-hyw mw-list-item"><a href="https://hyw.wikipedia.org/wiki/%D5%87%D5%B6%D5%B9%D5%A1%D6%83%D5%B8%D5%B2%D5%A1%D5%AE%D5%A1%D5%AF%D5%B8%D6%82%D5%B4" title="Շնչափողածակում – Western Armenian" lang="hyw" hreflang="hyw" data-title="Շնչափողածակում" data-language-autonym="Արեւմտահայերէն" data-language-local-name="Western Armenian" class="interlanguage-link-target"><span>Արեւմտահայերէն</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%9F%E0%A7%8D%E0%A6%B0%E0%A7%8D%E0%A6%AF%E0%A6%BE%E0%A6%95%E0%A6%BF%E0%A6%93%E0%A6%9F%E0%A6%AE%E0%A6%BF" title="ট্র্যাকিওটমি – Bangla" lang="bn" hreflang="bn" data-title="ট্র্যাকিওটমি" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Traqueotomia" title="Traqueotomia – Catalan" lang="ca" hreflang="ca" data-title="Traqueotomia" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Tracheotomie" title="Tracheotomie – Czech" lang="cs" hreflang="cs" data-title="Tracheotomie" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Tracheostomi" title="Tracheostomi – Danish" lang="da" hreflang="da" data-title="Tracheostomi" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Tracheotomie" title="Tracheotomie – German" lang="de" hreflang="de" data-title="Tracheotomie" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%A4%CF%81%CE%B1%CF%87%CE%B5%CE%B9%CE%BF%CF%84%CE%BF%CE%BC%CE%AE" title="Τραχειοτομή – Greek" lang="el" hreflang="el" data-title="Τραχειοτομή" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Traqueotom%C3%ADa" title="Traqueotomía – Spanish" lang="es" hreflang="es" data-title="Traqueotomía" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Trakeotomia" title="Trakeotomia – Basque" lang="eu" hreflang="eu" data-title="Trakeotomia" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%AA%D8%B1%D8%A7%DA%A9%D8%B3%D8%AA%D9%88%D9%85%DB%8C" title="تراکستومی – Persian" lang="fa" hreflang="fa" data-title="تراکستومی" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Trach%C3%A9otomie" title="Trachéotomie – French" lang="fr" hreflang="fr" data-title="Trachéotomie" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EA%B8%B0%EA%B4%80%EC%A0%88%EA%B0%9C%EC%88%A0" title="기관절개술 – Korean" lang="ko" hreflang="ko" data-title="기관절개술" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%87%D5%B6%D5%B9%D5%A1%D6%83%D5%B8%D5%B2%D5%A1%D5%B0%D5%A1%D5%BF%D5%B8%D6%82%D5%B4" title="Շնչափողահատում – Armenian" lang="hy" hreflang="hy" data-title="Շնչափողահատում" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-io mw-list-item"><a href="https://io.wikipedia.org/wiki/Trakeotomio" title="Trakeotomio – Ido" lang="io" hreflang="io" data-title="Trakeotomio" data-language-autonym="Ido" data-language-local-name="Ido" class="interlanguage-link-target"><span>Ido</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Tracheotomia" title="Tracheotomia – Italian" lang="it" hreflang="it" data-title="Tracheotomia" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%A4%D7%99%D7%95%D7%9D_%D7%A7%D7%A0%D7%94" title="פיום קנה – Hebrew" lang="he" hreflang="he" data-title="פיום קנה" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%A2%E1%83%A0%E1%83%90%E1%83%A5%E1%83%94%E1%83%9D%E1%83%A2%E1%83%9D%E1%83%9B%E1%83%98%E1%83%90" title="ტრაქეოტომია – Georgian" lang="ka" hreflang="ka" data-title="ტრაქეოტომია" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target"><span>ქართული</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%A2%D1%80%D0%B0%D1%85%D0%B5%D0%BE%D1%81%D1%82%D0%BE%D0%BC%D0%B8%D1%8F" title="Трахеостомия – Kazakh" lang="kk" hreflang="kk" data-title="Трахеостомия" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%A2%D1%80%D0%B0%D1%85%D0%B5%D0%BE%D1%82%D0%BE%D0%BC%D0%B8%D1%8F" title="Трахеотомия – Kyrgyz" lang="ky" hreflang="ky" data-title="Трахеотомия" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target"><span>Кыргызча</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Tracheotomija" title="Tracheotomija – Lithuanian" lang="lt" hreflang="lt" data-title="Tracheotomija" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Tracheotomie" title="Tracheotomie – Dutch" lang="nl" hreflang="nl" data-title="Tracheotomie" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja badge-Q17437798 badge-goodarticle mw-list-item" title="good article badge"><a href="https://ja.wikipedia.org/wiki/%E6%B0%97%E7%AE%A1%E5%88%87%E9%96%8B" title="気管切開 – Japanese" lang="ja" hreflang="ja" data-title="気管切開" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Trakeotomi" title="Trakeotomi – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Trakeotomi" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Traxeostomiya" title="Traxeostomiya – Uzbek" lang="uz" hreflang="uz" data-title="Traxeostomiya" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Tracheotomia" title="Tracheotomia – Polish" lang="pl" hreflang="pl" data-title="Tracheotomia" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Traqueostomia" title="Traqueostomia – Portuguese" lang="pt" hreflang="pt" data-title="Traqueostomia" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%A2%D1%80%D0%B0%D1%85%D0%B5%D0%BE%D1%81%D1%82%D0%BE%D0%BC%D0%B8%D1%8F" title="Трахеостомия – Russian" lang="ru" hreflang="ru" data-title="Трахеостомия" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Tracheotomy" title="Tracheotomy – Simple English" lang="en-simple" hreflang="en-simple" data-title="Tracheotomy" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Traheotomija" title="Traheotomija – Serbian" lang="sr" hreflang="sr" data-title="Traheotomija" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Trakeostomia" title="Trakeostomia – Finnish" lang="fi" hreflang="fi" data-title="Trakeostomia" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Trakeotomi" title="Trakeotomi – Swedish" lang="sv" hreflang="sv" data-title="Trakeotomi" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%9F%E0%AE%BF%E0%AE%B0%E0%AE%95%E0%AF%8D%E0%AE%95%E0%AE%BF%E0%AE%AF%E0%AF%8B%E0%AE%9F%E0%AF%8B%E0%AE%AE%E0%AE%BF" title="டிரக்கியோடோமி – Tamil" lang="ta" hreflang="ta" data-title="டிரக்கியோடோமி" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%81%E0%B8%B2%E0%B8%A3%E0%B9%80%E0%B8%88%E0%B8%B2%E0%B8%B0%E0%B8%84%E0%B8%AD" title="การเจาะคอ – Thai" lang="th" hreflang="th" data-title="การเจาะคอ" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Trakeostomi" title="Trakeostomi – Turkish" lang="tr" hreflang="tr" data-title="Trakeostomi" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%A2%D1%80%D0%B0%D1%85%D0%B5%D0%BE%D1%81%D1%82%D0%BE%D0%BC%D1%96%D1%8F" title="Трахеостомія – Ukrainian" lang="uk" hreflang="uk" data-title="Трахеостомія" data-language-autonym="Українська" data-language-local-name="Ukrainian" 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class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Temporary surgical incision to create an airway into the trachea</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">For a similar procedure, see <a href="/wiki/Cricothyrotomy" title="Cricothyrotomy">Cricothyrotomy</a>.</div> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical intervention</div> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Tracheotomy</th></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Traqueostomia.png" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/d/d9/Traqueostomia.png" decoding="async" width="166" height="308" class="mw-file-element" data-file-width="166" data-file-height="308" /></a></span><div class="infobox-caption">Completed <b>tracheotomy</b>:<br /> <p>1 – <a href="/wiki/Vocal_folds" class="mw-redirect" title="Vocal folds">Vocal folds</a><br /> 2 – <a href="/wiki/Thyroid_cartilage" title="Thyroid cartilage">Thyroid cartilage</a><br /> 3 – <a href="/wiki/Cricoid_cartilage" title="Cricoid cartilage">Cricoid cartilage</a><br /> 4 – <a href="/wiki/Tracheal_rings" class="mw-redirect" title="Tracheal rings">Tracheal rings</a><br /> </p> 5 – Balloon cuff</div></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/ICD-10_Procedure_Coding_System" title="ICD-10 Procedure Coding System">ICD-10-PCS</a></th><td class="infobox-data">0B110F4</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/ICD-9-CM_Volume_3" title="ICD-9-CM Volume 3">ICD-9-CM</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="http://icd9cm.chrisendres.com/index.php?srchtype=procs&srchtext=31.1&Submit=Search&action=search">31.1</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D014140">D014140</a></span></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://medlineplus.gov/ency/article/002955.htm">002955</a></span></td></tr><tr class="noprint"><td colspan="2" class="infobox-full-data"><div style="text-align: right;">[<a href="https://www.wikidata.org/wiki/Q324921" class="extiw" title="d:Q324921">edit on Wikidata</a>]</div></td></tr></tbody></table> <p><b>Tracheotomy</b> (<span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ˌ/: secondary stress follows">ˌ</span><span title="'t' in 'tie'">t</span><span title="'r' in 'rye'">r</span><span title="/eɪ/: 'a' in 'face'">eɪ</span><span title="'k' in 'kind'">k</span><span title="/i/: 'y' in 'happy'">i</span><span title="/ˈ/: primary stress follows">ˈ</span><span title="/ɒ/: 'o' in 'body'">ɒ</span><span title="'t' in 'tie'">t</span><span title="/ə/: 'a' in 'about'">ə</span><span title="'m' in 'my'">m</span><span title="/i/: 'y' in 'happy'">i</span></span>/</a></span></span>, <span style="font-size:85%;">UK also</span> <span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="/ˌ/: secondary stress follows">ˌ</span><span title="'t' in 'tie'">t</span><span title="'r' in 'rye'">r</span><span title="/æ/: 'a' in 'bad'">æ</span><span title="'k' in 'kind'">k</span><span title="/i/: 'y' in 'happy'">i</span></span>-/</a></span></span>), or <b>tracheostomy</b>, is a <a href="/wiki/Surgical_airway_management" title="Surgical airway management">surgical airway management</a> procedure which consists of making an incision on the front of the neck to open a direct airway to the <a href="/wiki/Vertebrate_trachea" class="mw-redirect" title="Vertebrate trachea">trachea</a>. The resulting <a href="/wiki/Stoma_(medicine)" title="Stoma (medicine)">stoma</a> (hole) can serve independently as an <a href="/wiki/Airway" class="mw-redirect" title="Airway">airway</a> or as a site for a <a href="/wiki/Tracheal_tube" title="Tracheal tube">tracheal tube</a> (or tracheostomy tube) to be inserted;<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> this tube allows a person to breathe without the use of the nose or mouth. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Etymology_and_terminology">Etymology and terminology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=1" title="Edit section: Etymology and terminology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure typeof="mw:File/Frame"><a href="/wiki/File:Tracheostomy_NIH.jpg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/e/ed/Tracheostomy_NIH.jpg" decoding="async" width="475" height="399" class="mw-file-element" data-file-width="475" data-file-height="399" /></a><figcaption>Figure A shows a side view of the neck and the correct placement of a tracheostomy tube in the trachea, or windpipe. Figure B shows an external view of a patient who has a tracheostomy.</figcaption></figure> <p>The <a href="/wiki/Etymology" title="Etymology">etymology</a> of the word <i>tracheotomy</i> comes from two <a href="/wiki/Greek_language" title="Greek language">Greek</a> words: the <a href="/wiki/Root_(linguistics)" title="Root (linguistics)">root</a> <i>tom-</i> (from <a href="/wiki/Ancient_Greek" title="Ancient Greek">Greek</a> τομή <i>tomḗ</i>) meaning "to cut", and the word <i>trachea</i> (from Greek τραχεία <i>tracheía</i>).<sup id="cite_ref-:0_2-0" class="reference"><a href="#cite_note-:0-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The word <i>tracheostomy</i>, including the root <i>stom-</i> (from Greek στόμα <i>stóma</i>) meaning "mouth", refers to the making of a semi-permanent or permanent opening and to the opening itself. Some sources offer different definitions of the above terms. Part of the ambiguity is due to the uncertainty of the intended permanence of the <a href="/wiki/Stoma_(medicine)" title="Stoma (medicine)">stoma</a> (hole) at the time it is created.<sup id="cite_ref-:1_3-0" class="reference"><a href="#cite_note-:1-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Indications">Indications</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=2" title="Edit section: Indications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There are four main reasons why someone would receive a tracheotomy:<sup id="cite_ref-:1_3-1" class="reference"><a href="#cite_note-:1-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <ol><li>Emergency airway access</li> <li>Airway access for prolonged mechanical ventilation</li> <li>Functional or mechanical upper airway obstruction</li> <li>Decreased/incompetent clearance of tracheobronchial secretions</li></ol> <p>In the acute (short term) setting, indications for tracheotomy include such conditions as severe <a href="/wiki/Facial_trauma" title="Facial trauma">facial trauma</a>, tumors of the head and neck (e.g., <a href="/wiki/Head_and_neck_cancer" title="Head and neck cancer">cancers</a>, <a href="/wiki/Branchial_cleft_cyst" title="Branchial cleft cyst">branchial cleft cysts</a>), and acute <a href="/wiki/Angioedema" title="Angioedema">angioedema</a> and <a href="/wiki/Inflammation" title="Inflammation">inflammation</a> of the head and neck. In the context of failed <a href="/wiki/Tracheal_intubation" title="Tracheal intubation">tracheal intubation</a>, either tracheotomy or <a href="/wiki/Cricothyrotomy" title="Cricothyrotomy">cricothyrotomy</a> may be performed.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2022)">citation needed</span></a></i>]</sup> </p> <figure class="mw-default-size mw-halign-left" typeof="mw:File/Thumb"><a href="/wiki/File:VIP_Bird2.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/9/94/VIP_Bird2.jpg/220px-VIP_Bird2.jpg" decoding="async" width="220" height="237" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/94/VIP_Bird2.jpg/330px-VIP_Bird2.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/94/VIP_Bird2.jpg/440px-VIP_Bird2.jpg 2x" data-file-width="664" data-file-height="714" /></a><figcaption>Tracheotomy tubes and <a href="/wiki/Endotracheal_tube" class="mw-redirect" title="Endotracheal tube">endotracheal tubes</a> are often attached to <a href="/wiki/Medical_ventilator" class="mw-redirect" title="Medical ventilator">ventilators</a> to assist in breathing.</figcaption></figure> <p>In the chronic (long-term) setting, indications for tracheotomy include the need for long-term mechanical ventilation and <a href="/wiki/Pulmonary_toilet" class="mw-redirect" title="Pulmonary toilet">tracheal toilet</a> (e.g., <a href="/wiki/Coma" title="Coma">comatose</a> patients, extensive surgery involving the head and neck). Tracheotomy may result in a significant reduction in the administration of <a href="/wiki/Sedative" title="Sedative">sedatives</a> and <a href="/wiki/Antihypotensive_agent" class="mw-redirect" title="Antihypotensive agent">vasopressors</a>, as well as the duration of stay in the <a href="/wiki/Intensive_care_unit" title="Intensive care unit">intensive care unit</a> (ICU).<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>In extreme cases, the procedure may be indicated as a treatment for severe <a href="/wiki/Obstructive_sleep_apnea" title="Obstructive sleep apnea">obstructive sleep apnea</a> (OSA) seen in patients intolerant of <a href="/wiki/Continuous_positive_airway_pressure" title="Continuous positive airway pressure">continuous positive airway pressure</a> (CPAP) therapy. The reason tracheostomy works well for OSA is because it is the <i>only</i> surgical procedure that completely bypasses the upper airway. This procedure was commonly performed for obstructive sleep apnea until the 1980s, when other procedures such as the <a href="/wiki/Uvulopalatopharyngoplasty" title="Uvulopalatopharyngoplasty">uvulopalatopharyngoplasty</a>, <a href="/wiki/Genioglossus_advancement" title="Genioglossus advancement">genioglossus advancement</a>, and <a href="/wiki/Maxillomandibular_advancement" title="Maxillomandibular advancement">maxillomandibular advancement</a> surgeries were described as alternative surgical modalities for OSA. </p><p>If prolonged ventilation is required, tracheostomy is usually considered. The timing of this procedure is dependent on the clinical situation and an individual's preference. An international multicenter study in 2000 determined that the median time between starting mechanical ventilation and receiving a tracheostomy was 11 days.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Although the definition varies depending on hospital and provider, early tracheostomy can be considered to be less than 10 days (2 to 14 days) and late tracheostomy to be 10 days or more. </p> <div class="mw-heading mw-heading2"><h2 id="Alternatives">Alternatives</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=3" title="Edit section: Alternatives"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Iron_lung" title="Iron lung">Biphasic cuirass ventilation</a> is a form of non-invasive mechanical ventilation that can — in a small subset of cases — allow people to avoid a tracheostomy.<sup id="cite_ref-Linton2005_6-0" class="reference"><a href="#cite_note-Linton2005-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Components">Components</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=4" title="Edit section: Components"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Tracheostomy_tube.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f6/Tracheostomy_tube.jpg/220px-Tracheostomy_tube.jpg" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f6/Tracheostomy_tube.jpg/330px-Tracheostomy_tube.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f6/Tracheostomy_tube.jpg/440px-Tracheostomy_tube.jpg 2x" data-file-width="800" data-file-height="599" /></a><figcaption>An outer cannula (top item) with inflatable cuff (top right), an inner cannula (center item) and an obturator (bottom item)</figcaption></figure> <p>A tracheostomy tube may be single or dual lumen, and also cuffed or uncuffed. A dual lumen tracheostomy tube consists of an outer cannula or main shaft, an inner cannula, and an obturator. The obturator is used when inserting the tracheostomy tube to guide the placement of the outer cannula and is removed once the outer cannula is in place. The outer cannula remains in place but, because of the buildup of secretions, there is an inner cannula that may be removed for cleaning after use or it may be replaced. Single-lumen tracheostomy tubes do not have a removable inner cannula, suitable for narrower airways. Cuffed tracheostomy tubes have inflatable balloons at the end of the tube to secure them in place. A tracheostomy tube may be fenestrated with one or several holes to let air through the <a href="/wiki/Larynx" title="Larynx">larynx</a>, allowing speech.<sup id="cite_ref-Taylor_7-0" class="reference"><a href="#cite_note-Taylor-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p><p>Special tracheostomy tube valves (such as the Passy-Muir valve<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup>) have been created to assist people in their speech. The patient can inhale through the unidirectional tube. Upon expiration, pressure causes the valve to close, redirecting air around the tube, past the vocal folds, producing sound.<sup id="cite_ref-Cullen1963_9-0" class="reference"><a href="#cite_note-Cullen1963-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Surgical_procedure">Surgical procedure</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=5" title="Edit section: Surgical procedure"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Open_surgical_tracheotomy_(OST)"><span id="Open_surgical_tracheotomy_.28OST.29"></span>Open surgical tracheotomy (OST)</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=6" title="Edit section: Open surgical tracheotomy (OST)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The typical procedure done is the open surgical tracheotomy (OST) and is usually done in a sterile operating room. The optimal patient position involves a cushion under the shoulders to extend the neck. Commonly a transverse (horizontal) incision is made two fingerbreadths above the <a href="/wiki/Suprasternal_notch" title="Suprasternal notch">suprasternal notch</a>. Alternatively, a vertical incision can be made in the midline of the neck from the thyroid cartilage to just above the suprasternal notch. Skin, subcutaneous tissue, and strap muscles (a specific group of neck muscles) are retracted aside to expose the thyroid isthmus, which can be cut or retracted upwards. After proper identification of the cricoid cartilage and placement of a tracheal hook to steady the trachea and pull it forward, the trachea is cut open, either through the space between cartilage rings or vertically across multiple rings (cruciate incision). Occasionally a section of a tracheal cartilage ring may be removed to make insertion of the tube easier. Once the incision is made, a properly sized tube is inserted. The tube is connected to a ventilator and adequate ventilation and oxygenation is confirmed. The tracheotomy apparatus is then attached to the neck with tracheotomy ties, skin sutures, or both.<sup id="cite_ref-:4_10-0" class="reference"><a href="#cite_note-:4-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:6_11-0" class="reference"><a href="#cite_note-:6-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Percutaneous_dilatational_tracheotomy_(PDT)"><span id="Percutaneous_dilatational_tracheotomy_.28PDT.29"></span>Percutaneous dilatational tracheotomy (PDT)</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=7" title="Edit section: Percutaneous dilatational tracheotomy (PDT)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The first widely accepted percutaneous tracheotomy technique was described by Pat Ciaglia, a New York surgeon, in 1985.<sup id="cite_ref-Ciaglia1985_12-0" class="reference"><a href="#cite_note-Ciaglia1985-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> The next widely used technique was developed in 1989 by <a href="/wiki/Bill_Griggs" title="Bill Griggs">Bill Griggs</a>, an Australian intensive care specialist.<sup id="cite_ref-Griggs1990_13-0" class="reference"><a href="#cite_note-Griggs1990-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> In 1995, Fantoni developed a translaryngeal approach of percutaneous tracheostomy.<sup id="cite_ref-:7_14-0" class="reference"><a href="#cite_note-:7-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> The Griggs and Ciaglia Blue Rhino techniques are the two main techniques in current use. A number of comparison studies have been undertaken between these two techniques with no clear differences emerging.<sup id="cite_ref-Ambesh2002_15-0" class="reference"><a href="#cite_note-Ambesh2002-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> An advantage of PDT over OST is the ability to perform the procedure at the patient's bedside. This significantly decreases costs and time/people-power needed for an operating room (OR) procedure.<sup id="cite_ref-:6_11-1" class="reference"><a href="#cite_note-:6-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Contraindications for percutaneous tracheostomy include infection at the site of tracheostomy, uncontrolled bleeding disorder, unstable cardiopulmonary status, patient unable to stay still, abnormal anatomy of the tracheolaryngeal structures.<sup id="cite_ref-:0_2-1" class="reference"><a href="#cite_note-:0-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Risks_and_complications">Risks and complications</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=8" title="Edit section: Risks and complications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>As with most other surgical procedures, some cases are more difficult than others. Surgery on children is more difficult because of their smaller size. Difficulties such as a short neck and bigger thyroid glands make the trachea hard to open.<sup id="cite_ref-Wharton1897_16-0" class="reference"><a href="#cite_note-Wharton1897-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> There are other difficulties with patients with irregular necks, the obese, and those with a large <a href="/wiki/Goitre" title="Goitre">goitre</a>. </p><p>The many possible complications include <a href="/wiki/Hemorrhage" class="mw-redirect" title="Hemorrhage">hemorrhage</a>, loss of airway, <a href="/wiki/Subcutaneous_emphysema" title="Subcutaneous emphysema">subcutaneous emphysema</a>, wound infections, stoma cellulites, fracture of tracheal rings, poor placement of the tracheostomy tube, and <a href="/wiki/Bronchospasm" title="Bronchospasm">bronchospasm</a>.<sup id="cite_ref-Ferlito2003_17-0" class="reference"><a href="#cite_note-Ferlito2003-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p><p>Early complications include infection, hemorrhage, <a href="/wiki/Pneumomediastinum" title="Pneumomediastinum">pneumomediastinum</a>, <a href="/wiki/Pneumothorax" title="Pneumothorax">pneumothorax</a>, <a href="/wiki/Tracheoesophageal_fistula" title="Tracheoesophageal fistula">tracheoesophageal fistula</a>, recurrent laryngeal nerve injury, and tube displacement. Delayed complications include <a href="/wiki/Tracheoinnominate_fistula" title="Tracheoinnominate fistula">tracheal-innominate artery fistula</a>, <a href="/wiki/Tracheal_stenosis" class="mw-redirect" title="Tracheal stenosis">tracheal stenosis</a>, delayed tracheoesophageal fistula, and tracheocutaneous fistula.<sup id="cite_ref-:4_10-1" class="reference"><a href="#cite_note-:4-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>A 2013 systematic review (published cases from 1985 to April 2013) studied the complications and risk factors of percutaneous dilatational tracheostomy (PDT), identifying major causes of fatality to be <a href="/wiki/Hemorrhage" class="mw-redirect" title="Hemorrhage">hemorrhage</a> (38.0%), airway complications (29.6%), tracheal perforation (15.5%), and <a href="/wiki/Pneumothorax" title="Pneumothorax">pneumothorax</a> (5.6%)<sup id="cite_ref-:2_18-0" class="reference"><a href="#cite_note-:2-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> A similar systematic review in 2017 (cases from 1990 to 2015) studying fatality in both open surgical tracheotomy (OST) and PDT identified similar rates of mortality and causes of death between the two techniques.<sup id="cite_ref-:5_19-0" class="reference"><a href="#cite_note-:5-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p><p><a href="/wiki/Hemorrhage" class="mw-redirect" title="Hemorrhage">Hemorrhage</a> is rare, but the most likely cause of fatality after a tracheostomy. It usually occurs due to a <a href="/wiki/Tracheoinnominate_fistula" title="Tracheoinnominate fistula">tracheoarterial fistula</a>, an abnormal connection between the trachea and nearby blood vessels, and most commonly manifests between 3 days to 6 weeks after the procedure is done. Fistulas can result from incorrectly positioned equipment, high cuff pressures causing pressure sores or mucosal damage, a low surgical trachea site, repetitive neck movement, radiotherapy, or prolonged intubation.<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> </p><p>A potential risk factor identified in a 2013 systematic review of the percutaneous technique was the lack of <a href="/wiki/Bronchoscopy" title="Bronchoscopy">bronchoscopic</a> guidance. Use of the bronchoscope, an instrument inserted through a patient's mouth for internal visualization of the airway, can help with proper placement of instruments and better visualization of anatomical structures. However, this can also be dependent on the skills and familiarity of the surgeon with both the procedure and the patient's anatomy.<sup id="cite_ref-:2_18-1" class="reference"><a href="#cite_note-:2-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p><p>There are a multitude of potential complications related to the airway. The main causes of mortality during PDT include dislodgment of the tube, loss of airway during procedure and misplacement of the tube.<sup id="cite_ref-:2_18-2" class="reference"><a href="#cite_note-:2-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> One of the more urgent complications include displacement or dislodgment of the tracheotomy tube, either spontaneously or during a tube change. Although uncommon (< 1/1000 tracheostomy tube days), the associated fatality is high due to the loss of airway.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Due to the seriousness of such a situation, individuals with a tracheotomy tube should consult with their healthcare providers to have a specific, written, emergency intubation and tracheostomy recannulation (reinsertion) plan prepared in advance. </p><p><a href="/wiki/Laryngotracheal_stenosis" title="Laryngotracheal stenosis">Tracheal stenosis</a>, otherwise known as an abnormal narrowing of the airway, is a possible long term complication. The most common symptom of stenosis is gradually-worsening difficulty with breathing (<a href="/wiki/Dyspnea" class="mw-redirect" title="Dyspnea">dyspnea</a>). However incidence is low, ranging from 0.6 to 2.8% with increased rates if major bleeding or wound infections are present. A 2016 systematic review identified a higher rate of tracheal stenosis in individuals who underwent a surgical tracheostomy, as compared to PDT, however the difference was not statistically significant.<sup id="cite_ref-:3_22-0" class="reference"><a href="#cite_note-:3-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> </p><p>A 2000 Spanish study of bedside percutaneous tracheostomy reported overall complication rates of 10–15% and a procedural mortality of 0%,<sup id="cite_ref-Anon2000_23-0" class="reference"><a href="#cite_note-Anon2000-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> which is comparable to those of other series reported in the literature from the Netherlands<sup id="cite_ref-VanHeurn1996_24-0" class="reference"><a href="#cite_note-VanHeurn1996-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Polderman2003_25-0" class="reference"><a href="#cite_note-Polderman2003-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> and the United States.<sup id="cite_ref-Hill1996_26-0" class="reference"><a href="#cite_note-Hill1996-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Powell1998_27-0" class="reference"><a href="#cite_note-Powell1998-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> A 2013 systematic review calculated procedural mortality to be 0.17% or 1 in 600 cases.<sup id="cite_ref-:2_18-3" class="reference"><a href="#cite_note-:2-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Multiple systematic reviews identified no significant difference in rates of mortality, major bleeding, or wound infection between the percutaneous or open surgical methods.<sup id="cite_ref-:3_22-1" class="reference"><a href="#cite_note-:3-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:5_19-1" class="reference"><a href="#cite_note-:5-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p><p>Specifically a 2017 systematic review calculated the most common causes of death and their frequencies, out of all tracheotomies, to be hemorrhage (OST: 0.26%, PDT: 0.19%), loss of airway (OST: 0.21%, PDT: 0.20%), and misplacement of tube (OST: 0.11%, PDT: 0.20%).<sup id="cite_ref-:5_19-2" class="reference"><a href="#cite_note-:5-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p><p>A 2003 American cadaveric study identified multiple tracheal ring fractures with the Ciaglia Blue Rhino technique as a complication occurring in 100% of their small series of cases.<sup id="cite_ref-Hotchkiss2003_28-0" class="reference"><a href="#cite_note-Hotchkiss2003-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> The comparative study above also identified ring fractures in 9 of 30 live patients<sup id="cite_ref-Ambesh2002_15-1" class="reference"><a href="#cite_note-Ambesh2002-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> while another small series identified ring fractures in 5 of their 20 patients.<sup id="cite_ref-Byhahn2000_29-0" class="reference"><a href="#cite_note-Byhahn2000-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> The long term significance of tracheal ring fractures is unknown.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2014)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=9" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Tracheotomy1.jpg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/8/8c/Tracheotomy1.jpg" decoding="async" width="200" height="259" class="mw-file-element" data-file-width="200" data-file-height="259" /></a><figcaption>A tracheostomy from prior to the 20th century</figcaption></figure> <div class="mw-heading mw-heading3"><h3 id="Ancient_history">Ancient history</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=10" title="Edit section: Ancient history"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Tracheotomy was first potentially depicted on <a href="/wiki/Egypt" title="Egypt">Egyptian</a> artifacts in 3600 BC.<sup id="cite_ref-AARC2001_30-0" class="reference"><a href="#cite_note-AARC2001-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Hippocrates" title="Hippocrates">Hippocrates</a> condemned the practice of tracheotomy as incurring an unacceptable risk of damage to the <a href="/wiki/Carotid_artery" title="Carotid artery">carotid artery</a>. Warning against the possibility of death from inadvertent laceration of the carotid artery during tracheotomy, he instead advocated the practice of <a href="/wiki/Tracheal_intubation" title="Tracheal intubation">tracheal intubation</a>.<sup id="cite_ref-Ferlito2003_17-1" class="reference"><a href="#cite_note-Ferlito2003-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p><p>Despite the concerns of Hippocrates, it is believed that an early tracheotomy was performed by <a href="/wiki/Asclepiades_of_Bithynia" title="Asclepiades of Bithynia">Asclepiades of Bithynia</a>, who lived in Rome around 100 BC.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Galen" title="Galen">Galen</a> and <a href="/wiki/Aretaeus" class="mw-redirect" title="Aretaeus">Aretaeus</a>, both of whom lived in Rome in the 2nd century AD, credit Asclepiades as being the first physician to perform a non-emergency tracheotomy. <a href="/wiki/Antyllus" title="Antyllus">Antyllus</a>, another Roman-era Greek 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 <a href="/wiki/Transverse_plane" title="Transverse plane">transverse</a> incision be made between the third and fourth tracheal rings for the treatment of life-threatening airway obstruction.<sup id="cite_ref-Ferlito2003_17-2" class="reference"><a href="#cite_note-Ferlito2003-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Medieval_world">Medieval world</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=11" title="Edit section: Medieval world"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The 7th century Byzantine physician <a href="/wiki/Paul_of_Aegina" title="Paul of Aegina">Paul of Aegina</a>, an advocate of the procedure, acknowledged previous Greek authors' works on the subject of tracheotomies and provided descriptions of the procedure in his own works.<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> In 1000, <a href="/wiki/Albucasis" class="mw-redirect" title="Albucasis">Abu al-Qasim al-Zahrawi</a> (936–1013), an Arab who lived in <a href="/wiki/Al-Andalus" title="Al-Andalus">Arabic Spain</a>, published the 30-volume <i><a href="/wiki/Al-Tasrif" title="Al-Tasrif">Kitab al-Tasrif</a></i>, 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 <i>Albucasis</i>) sewed up the wound and the girl recovered, thereby proving that an incision in the larynx could heal. Circa AD 1020, <a href="/wiki/Avicenna" title="Avicenna">Avicenna</a> (980–1037) described tracheal intubation in <i><a href="/wiki/The_Canon_of_Medicine" title="The Canon of Medicine">The Canon of Medicine</a></i> in order to facilitate <a href="/wiki/Breathing" title="Breathing">breathing</a>.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> The first clear description of the tracheotomy operation for treating asphyxiation was given by <a href="/wiki/Ibn_Zuhr" title="Ibn Zuhr">Ibn Zuhr</a> (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.<sup id="cite_ref-Shehata_34-0" class="reference"><a href="#cite_note-Shehata-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="16th–18th_centuries"><span id="16th.E2.80.9318th_centuries"></span>16th–18th centuries</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=12" title="Edit section: 16th–18th centuries"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Girolamo_Fabrizi_d%27Acquapendente.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/b/bd/Girolamo_Fabrizi_d%27Acquapendente.jpg/220px-Girolamo_Fabrizi_d%27Acquapendente.jpg" decoding="async" width="220" height="222" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/b/bd/Girolamo_Fabrizi_d%27Acquapendente.jpg/330px-Girolamo_Fabrizi_d%27Acquapendente.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/b/bd/Girolamo_Fabrizi_d%27Acquapendente.jpg/440px-Girolamo_Fabrizi_d%27Acquapendente.jpg 2x" data-file-width="1187" data-file-height="1200" /></a><figcaption><a href="/wiki/Hieronymus_Fabricius" title="Hieronymus Fabricius">Hieronymus Fabricius</a> (1533–1619) was the first to introduce the idea of a tracheostomy tube</figcaption></figure> <p>The European <a href="/wiki/Renaissance" title="Renaissance">Renaissance</a> 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,<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers" title="Wikipedia:Manual of Style/Dates and numbers"><span title="This term requires quantification. (January 2012)">quantify</span></a></i>]</sup> and many surgeons still considered the tracheotomy to be a useless and dangerous procedure. The high mortality rate<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Manual_of_Style/Dates_and_numbers" title="Wikipedia:Manual of Style/Dates and numbers"><span title="This term requires quantification. (January 2012)">quantify</span></a></i>]</sup> for this operation, which had not improved, supported their position. From the period 1500 to 1832 there are only 28 known reports of tracheotomy.<sup id="cite_ref-Goodall1934_35-0" class="reference"><a href="#cite_note-Goodall1934-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p><p>In 1543, <a href="/wiki/Andreas_Vesalius" title="Andreas Vesalius">Andreas Vesalius</a> (1514–1564) wrote that tracheal intubation and subsequent <a href="/wiki/Artificial_respiration" class="mw-redirect" title="Artificial respiration">artificial respiration</a> could be life-saving. <a href="/wiki/Antonio_Musa_Brassavola" title="Antonio Musa Brassavola">Antonio Musa Brassavola</a> (1490–1554) of <a href="/wiki/Ferrara" title="Ferrara">Ferrara</a> treated a patient with <a href="/wiki/Peritonsillar_abscess" title="Peritonsillar abscess">peritonsillar abscess</a> by tracheotomy after the patient had been refused by <a href="/wiki/Barber_surgeon" title="Barber surgeon">barber surgeons</a>. 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.<sup id="cite_ref-Goodall1934_35-1" class="reference"><a href="#cite_note-Goodall1934-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Ambroise_Par%C3%A9" title="Ambroise Paré">Ambroise Paré</a> (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. </p><p>Towards the end of the 16th century, anatomist and surgeon <a href="/wiki/Hieronymus_Fabricius" title="Hieronymus Fabricius">Hieronymus Fabricius</a> (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 <a href="/wiki/Cannula" title="Cannula">cannula</a> 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 <a href="/wiki/Airway" class="mw-redirect" title="Airway">airway</a> obstruction by <a href="/wiki/Foreign_body" title="Foreign body">foreign bodies</a> or <a href="/wiki/Secretion" title="Secretion">secretions</a>. Fabricius' description of the tracheotomy procedure is similar to that used today. <a href="/wiki/Giulio_Cesare_Casseri" title="Giulio Cesare Casseri">Giulio Cesare Casseri</a> (1552–1616) succeeded Fabricius as professor of anatomy at the University of Padua and published his own writings regarding technique and equipment for tracheotomy. Casseri recommended using a curved silver tube with several holes in it. <a href="/wiki/Marco_Aurelio_Severino" title="Marco Aurelio Severino">Marco Aurelio Severino</a> (1580–1656), a skillful surgeon and anatomist, performed multiple successful tracheotomies during a <a href="/wiki/Diphtheria" title="Diphtheria">diphtheria</a> <a href="/wiki/Epidemic" title="Epidemic">epidemic</a> in <a href="/wiki/Naples" title="Naples">Naples</a> in 1610, using the vertical incision technique recommended by Fabricius. He also developed his own version of a trocar.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> </p><p>In 1620 the French surgeon <a href="/w/index.php?title=Nicholas_Habicot&action=edit&redlink=1" class="new" title="Nicholas Habicot (page does not exist)">Nicholas Habicot</a> (1550–1624), surgeon of the <a href="/wiki/Duke_of_Nemours" title="Duke of Nemours">Duke of Nemours</a> and anatomist, published a report of four successful "bronchotomies" which he had performed.<sup id="cite_ref-Habicot1620_37-0" class="reference"><a href="#cite_note-Habicot1620-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> 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 <a href="/wiki/Pediatrics" title="Pediatrics">pediatric</a> patient. A 14-year-old boy swallowed a bag containing 9 gold coins in an attempt to prevent its theft by a <a href="/wiki/Highwayman" title="Highwayman">highwayman</a>. The object became lodged in his <a href="/wiki/Esophagus" title="Esophagus">esophagus</a>, obstructing his trachea. Habicot suggested that the operation might also be effective for patients with 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).<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (January 2022)">citation needed</span></a></i>]</sup> </p><p><a href="/wiki/Sanctorius" class="mw-redirect" title="Sanctorius">Sanctorius</a> (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.<sup id="cite_ref-Sanctorii1646_38-0" class="reference"><a href="#cite_note-Sanctorii1646-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> Early tracheostomy devices are illustrated in Habicot's <i>Question Chirurgicale</i><sup id="cite_ref-Habicot1620_37-1" class="reference"><a href="#cite_note-Habicot1620-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> and Casseri's posthumous <i>Tabulae anatomicae</i> in 1627.<sup id="cite_ref-Casserius1632_39-0" class="reference"><a href="#cite_note-Casserius1632-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> Thomas Fienus (1567–1631), Professor of Medicine at the <a href="/wiki/Old_University_of_Leuven" title="Old University of Leuven">University of Louvain</a>, was the first to use the word "tracheotomy" in 1649, but this term was not commonly used until a century later.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> Georg Detharding (1671–1747), professor of anatomy at the <a href="/wiki/University_of_Rostock" title="University of Rostock">University of Rostock</a>, treated a drowning victim with tracheostomy in 1714.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="19th_century">19th century</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=13" title="Edit section: 19th century"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In the 1820s, the tracheotomy began to be recognized as a legitimate means of treating severe airway obstruction. In 1832, French physician <a href="/wiki/Pierre_Bretonneau" title="Pierre Bretonneau">Pierre Bretonneau</a> employed it as a last resort to treat a case of <a href="/wiki/Diphtheria" title="Diphtheria">diphtheria</a>.<sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> In 1852, Bretonneau's student <a href="/wiki/Armand_Trousseau" title="Armand Trousseau">Armand Trousseau</a> reported a series of 169 tracheotomies (158 of which were for <a href="/wiki/Croup" title="Croup">croup</a>, and 11 for "chronic maladies of the larynx")<sup id="cite_ref-45" class="reference"><a href="#cite_note-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup> 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.<sup id="cite_ref-Snow1858_46-0" class="reference"><a href="#cite_note-Snow1858-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup> In 1871, the German surgeon <a href="/wiki/Friedrich_Trendelenburg" title="Friedrich Trendelenburg">Friedrich Trendelenburg</a> (1844–1924) published a paper describing the first successful <a href="/wiki/Choice" title="Choice">elective</a> human tracheotomy to be performed for the purpose of administration of general anesthesia.<sup id="cite_ref-Trendelenburg1871_47-0" class="reference"><a href="#cite_note-Trendelenburg1871-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> In 1880, the Scottish surgeon <a href="/wiki/William_Macewen" title="William Macewen">William Macewen</a> (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 <a href="/wiki/Chloroform" title="Chloroform">chloroform</a>.<sup id="cite_ref-Macewen18800724_48-0" class="reference"><a href="#cite_note-Macewen18800724-48"><span class="cite-bracket">[</span>48<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Macewen18800731_49-0" class="reference"><a href="#cite_note-Macewen18800731-49"><span class="cite-bracket">[</span>49<span class="cite-bracket">]</span></a></sup> At last, in 1880 <a href="/wiki/Morell_Mackenzie" title="Morell Mackenzie">Morell Mackenzie</a>'s book discussed the symptoms indicating a tracheotomy and when the operation is absolutely necessary.<sup id="cite_ref-Ferlito2003_17-3" class="reference"><a href="#cite_note-Ferlito2003-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="20th_century">20th century</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=14" title="Edit section: 20th century"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-Unreferenced_section plainlinks metadata ambox ambox-content ambox-Unreferenced" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><a href="/wiki/File:Question_book-new.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/50px-Question_book-new.svg.png" decoding="async" width="50" height="39" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/75px-Question_book-new.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/100px-Question_book-new.svg.png 2x" data-file-width="512" data-file-height="399" /></a></span></div></td><td class="mbox-text"><div class="mbox-text-span">This section <b>does not <a href="/wiki/Wikipedia:Citing_sources" title="Wikipedia:Citing sources">cite</a> any <a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability">sources</a></b>.<span class="hide-when-compact"> Please help <a href="/wiki/Special:EditPage/Tracheotomy" title="Special:EditPage/Tracheotomy">improve this section</a> by <a href="/wiki/Help:Referencing_for_beginners" title="Help:Referencing for beginners">adding citations to reliable sources</a>. Unsourced material may be challenged and <a href="/wiki/Wikipedia:Verifiability#Burden_of_evidence" title="Wikipedia:Verifiability">removed</a>.</span> <span class="date-container"><i>(<span class="date">May 2024</span>)</i></span><span class="hide-when-compact"><i> (<small><a href="/wiki/Help:Maintenance_template_removal" title="Help:Maintenance template removal">Learn how and when to remove this message</a></small>)</i></span></div></td></tr></tbody></table> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Cricothyrotomy.png" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/0/01/Cricothyrotomy.png/170px-Cricothyrotomy.png" decoding="async" width="170" height="243" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/0/01/Cricothyrotomy.png/255px-Cricothyrotomy.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/0/01/Cricothyrotomy.png/340px-Cricothyrotomy.png 2x" data-file-width="888" data-file-height="1268" /></a><figcaption>Laryngeal structures, trachea (1–4) and invasive procedures (A–B) (1) Thyroid cartilage (2) Cricothyroid ligament (3) Cricoid cartilage (4) Trachea (A) Cricothyrotomy (B) Tracheotomy</figcaption></figure> <p>In the early 20th century, physicians began to use the tracheotomy in the treatment of patients affected by paralytic <a href="/wiki/Poliomyelitis" class="mw-redirect" title="Poliomyelitis">poliomyelitis</a> who required <a href="/wiki/Mechanical_ventilation" title="Mechanical ventilation">mechanical ventilation</a>. 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 <a href="/wiki/Surgical_instrument" title="Surgical instrument">surgical instruments</a> 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 <a href="/wiki/Chevalier_Jackson" title="Chevalier Jackson">Chevalier Jackson</a> of <a href="/wiki/Pittsburgh" title="Pittsburgh">Pittsburgh</a>, <a href="/wiki/Pennsylvania" title="Pennsylvania">Pennsylvania</a>. Jackson emphasised the importance of postoperative care, which dramatically reduced the death rate. By 1965, the surgical anatomy was thoroughly and widely understood, <a href="/wiki/Antibiotic" title="Antibiotic">antibiotics</a> were widely available and useful for treating postoperative infections, and other major complications had also become more manageable. </p> <div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=15" title="Edit section: Society and culture"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Notable individuals who have or have had a tracheotomy include <a href="/wiki/Catherine_Zeta-Jones" title="Catherine Zeta-Jones">Catherine Zeta-Jones</a>, <a href="/wiki/Mika_H%C3%A4kkinen" title="Mika Häkkinen">Mika Häkkinen</a>, <a href="/wiki/Stephen_Hawking" title="Stephen Hawking">Stephen Hawking</a>, <a href="/wiki/Connie_Culp" title="Connie Culp">Connie Culp</a>, <a href="/wiki/Christopher_Reeve" title="Christopher Reeve">Christopher Reeve</a>,<sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">[</span>50<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Roy_Horn" class="mw-redirect" title="Roy Horn">Roy Horn</a>, <a href="/wiki/William_Rehnquist" title="William Rehnquist">William Rehnquist</a>, <a href="/wiki/Gabby_Giffords" title="Gabby Giffords">Gabby Giffords</a>, <a href="/wiki/George_Michael" title="George Michael">George Michael</a>, <a href="/wiki/Val_Kilmer" title="Val Kilmer">Val Kilmer</a>,<sup id="cite_ref-ValKilmerTracheotomy_51-0" class="reference"><a href="#cite_note-ValKilmerTracheotomy-51"><span class="cite-bracket">[</span>51<span class="cite-bracket">]</span></a></sup> and many others.<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">[</span>52<span class="cite-bracket">]</span></a></sup> </p><p>Across movies and TV shows, there are many situations where an emergency procedure is done on an individual's neck to re-establish an airway. An example is in the 2008 horror film, <i><a href="/wiki/Saw_V" title="Saw V">Saw V</a></i>, in which a character being drowned from the neck up performs a manual tracheotomy, stabbing his neck with a pen to create an airway to breathe through. The most common procedure is a <a href="/wiki/Cricothyrotomy" title="Cricothyrotomy">cricothyrotomy</a> (or "crike"), which is an incision through the skin and cricothyroid membrane. This is often confused or misnamed as a tracheotomy (or "trach") and vice versa. However, they are quite different based on location of the opening and length of time the alternate airway is needed. </p><p>Another example of an emergency attempt at this procedure is featured in the 2013 comedy film <a href="/wiki/The_Heat_(film)" title="The Heat (film)">The Heat</a>, where <a href="/wiki/Sandra_Bullock" title="Sandra Bullock">Sandra Bullock</a>’s character, Sarah Ashburn, attempts to perform the operation on a person choking on a pancake in a <a href="/wiki/Denny%27s" title="Denny's">Denny's</a>, but fails. <a href="/wiki/Melissa_McCarthy" title="Melissa McCarthy">Melissa McCarthy</a>’s character, Detective Mullens, then presses hard on the man's chest, causing the piece of food to be expelled from his mouth.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2024)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=16" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFMolnar2023" class="citation web cs1">Molnar, Heather (11 April 2023). <a rel="nofollow" class="external text" href="http://www.hopkinsmedicine.org/tracheostomy/about/types.html">"Types of Tracheostomy Tubes"</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Types+of+Tracheostomy+Tubes&rft.date=2023-04-11&rft.aulast=Molnar&rft.aufirst=Heather&rft_id=http%3A%2F%2Fwww.hopkinsmedicine.org%2Ftracheostomy%2Fabout%2Ftypes.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATracheotomy" class="Z3988"></span></span> </li> <li id="cite_note-:0-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-:0_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:0_2-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRomaine_F._Johnson2003" class="citation web cs1">Romaine F. 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In Fundukian LJ (ed.). <i>The Gale Encyclopedia of Alternative Medicine</i> (3rd ed.). <a href="/wiki/Farmington_Hills,_Michigan" title="Farmington Hills, Michigan">Farmington Hills, Michigan</a>: <a href="/wiki/Gale_(publisher)" title="Gale (publisher)">Gale Cengage</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-1-4144-4872-5" title="Special:BookSources/978-1-4144-4872-5"><bdi>978-1-4144-4872-5</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Unani-tibbi&rft.btitle=The+Gale+Encyclopedia+of+Alternative+Medicine&rft.place=Farmington+Hills%2C+Michigan&rft.edition=3rd&rft.pub=Gale+Cengage&rft.date=2008&rft.isbn=978-1-4144-4872-5&rft.au=Patricia+Skinner&rft_id=http%3A%2F%2Ffindarticles.com%2Fp%2Farticles%2Fmi_g2603%2Fis_0007%2Fai_2603000716%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATracheotomy" class="Z3988"></span></span> </li> <li id="cite_note-Shehata-34"><span class="mw-cite-backlink"><b><a href="#cite_ref-Shehata_34-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMostafa_Shehata2003" class="citation journal cs1">Mostafa Shehata (April 2003). <a rel="nofollow" class="external text" href="http://www.ishim.net/ishimj/3/01.pdf">"The Ear, Nose and Throat in Islamic Medicine"</a> <span class="cs1-format">(PDF)</span>. <i>Journal of the International Society for the History of Islamic Medicine</i>. <b>2</b> (3): <span class="nowrap">2–</span>5. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1303-667X">1303-667X</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+the+International+Society+for+the+History+of+Islamic+Medicine&rft.atitle=The+Ear%2C+Nose+and+Throat+in+Islamic+Medicine&rft.volume=2&rft.issue=3&rft.pages=%3Cspan+class%3D%22nowrap%22%3E2-%3C%2Fspan%3E5&rft.date=2003-04&rft.issn=1303-667X&rft.au=Mostafa+Shehata&rft_id=http%3A%2F%2Fwww.ishim.net%2Fishimj%2F3%2F01.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATracheotomy" class="Z3988"></span></span> </li> <li id="cite_note-Goodall1934-35"><span class="mw-cite-backlink">^ <a href="#cite_ref-Goodall1934_35-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Goodall1934_35-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGoodall1934" class="citation journal cs1">Goodall, E.W. (1934). 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Supplementum</i>. <b>374</b> (5179): <span class="nowrap">113–</span>5. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fbmj.1.5179.1129">10.1136/bmj.1.5179.1129</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1966956">1966956</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/1966956">1966956</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Acta+Radiologica.+Supplementum&rft.atitle=Recent+advances+in+psychiatric+brain+imaging&rft.volume=374&rft.issue=5179&rft.pages=%3Cspan+class%3D%22nowrap%22%3E113-%3C%2Fspan%3E5&rft.date=1960&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1966956%23id-name%3DPMC&rft_id=info%3Apmid%2F1966956&rft_id=info%3Adoi%2F10.1136%2Fbmj.1.5179.1129&rft.aulast=Sedvall&rft.aufirst=G&rft.au=Farde%2C+L&rft.au=Nyb%C3%A4ck%2C+H&rft.au=Pauli%2C+S&rft.au=Persson%2C+A&rft.au=Savic%2C+I&rft.au=Wiesel%2C+FA&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1966956&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATracheotomy" class="Z3988"></span></span> </li> <li id="cite_note-Habicot1620-37"><span class="mw-cite-backlink">^ <a href="#cite_ref-Habicot1620_37-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Habicot1620_37-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFNicholas_Habicot1620" class="citation book cs1 cs1-prop-foreign-lang-source">Nicholas Habicot (1620). <i>Question chirurgicale par laquelle il est démonstré que le Chirurgien doit assurément practiquer l'operation de la Bronchotomie, vulgairement dicte Laryngotomie, ou perforation de la fluste ou du polmon</i> (in French). Paris: Corrozet. p. 108.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Question+chirurgicale+par+laquelle+il+est+d%C3%A9monstr%C3%A9+que+le+Chirurgien+doit+assur%C3%A9ment+practiquer+l%27operation+de+la+Bronchotomie%2C+vulgairement+dicte+Laryngotomie%2C+ou+perforation+de+la+fluste+ou+du+polmon&rft.place=Paris&rft.pages=108&rft.pub=Corrozet&rft.date=1620&rft.au=Nicholas+Habicot&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATracheotomy" class="Z3988"></span></span> </li> <li id="cite_note-Sanctorii1646-38"><span class="mw-cite-backlink"><b><a href="#cite_ref-Sanctorii1646_38-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSanctorii_Sanctorii1646" class="citation book cs1 cs1-prop-foreign-lang-source"><a href="/wiki/Sanctorius" class="mw-redirect" title="Sanctorius">Sanctorii Sanctorii</a> (1646). <a rel="nofollow" class="external text" href="https://openlibrary.org/works/OL5226737W/Sanctorii_Sanctorii_Commentaria_in_primum_fen_primi_libri_canonis_Auicennæ_.."><i>Sanctorii Sanctorii Commentaria in primum fen, primi libri canonis Avicennæ</i></a> (in Latin). 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Daniel Bucretius ... XX. que deerant supplevit & omnium explicationes addidit</i></a> (in Latin). 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class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20749636">20749636</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=British+Medical+Journal&rft.atitle=Clinical+Observations+on+the+Introduction+of+Tracheal+Tubes+by+the+Mouth%2C+Instead+of+Performing+Tracheotomy+or+Laryngotomy&rft.volume=2&rft.issue=1022&rft.pages=%3Cspan+class%3D%22nowrap%22%3E163-%3C%2Fspan%3E5&rft.date=1880-07&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2241109%23id-name%3DPMC&rft_id=info%3Apmid%2F20749636&rft_id=info%3Adoi%2F10.1136%2Fbmj.2.1022.163&rft.aulast=Macewen&rft.aufirst=W&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2241109&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATracheotomy" class="Z3988"></span></span> </li> <li id="cite_note-50"><span class="mw-cite-backlink"><b><a href="#cite_ref-50">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.chrisreevehomepage.com/biography.html">"Biography (Christopher Reeve Homepage)"</a>. <i>www.chrisreevehomepage.com</i><span class="reference-accessdate">. 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Retrieved <span class="nowrap">14 June</span> 2022</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Fox+News&rft.atitle=Val+Kilmer+says+he%27s+doing+great+after+tracheotomy%3A+%27I+feel+a+lot+better+than+I+sound%27&rft.date=2020-08-03&rft.aulast=Day&rft.aufirst=Nate&rft_id=https%3A%2F%2Fwww.foxnews.com%2Fentertainment%2Fval-kilmer-doing-a-lot-better-after-tracheotomy&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATracheotomy" class="Z3988"></span></span> </li> <li id="cite_note-52"><span class="mw-cite-backlink"><b><a href="#cite_ref-52">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20181224075316/http://www.tracheostomy.com/resources/more/famous/index.htm">"Famous people who have or have had Tracheostomies"</a>. <i>www.tracheostomy.com</i>. Archived from <a rel="nofollow" class="external text" href="http://www.tracheostomy.com/resources/more/famous/index.htm">the original</a> on 24 December 2018<span class="reference-accessdate">. Retrieved <span class="nowrap">19 December</span> 2018</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=www.tracheostomy.com&rft.atitle=Famous+people+who+have+or+have+had+Tracheostomies&rft_id=http%3A%2F%2Fwww.tracheostomy.com%2Fresources%2Fmore%2Ffamous%2Findex.htm&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATracheotomy" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=17" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239549316">.mw-parser-output .refbegin{margin-bottom:0.5em}.mw-parser-output .refbegin-hanging-indents>ul{margin-left:0}.mw-parser-output .refbegin-hanging-indents>ul>li{margin-left:0;padding-left:3.2em;text-indent:-3.2em}.mw-parser-output .refbegin-hanging-indents ul,.mw-parser-output .refbegin-hanging-indents ul li{list-style:none}@media(max-width:720px){.mw-parser-output .refbegin-hanging-indents>ul>li{padding-left:1.6em;text-indent:-1.6em}}.mw-parser-output .refbegin-columns{margin-top:0.3em}.mw-parser-output .refbegin-columns ul{margin-top:0}.mw-parser-output .refbegin-columns li{page-break-inside:avoid;break-inside:avoid-column}@media screen{.mw-parser-output .refbegin{font-size:90%}}</style><div class="refbegin" style=""> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFPlotnikowRouxFeldGogniat2013" class="citation journal cs1">Plotnikow GA, Roux N, Feld V, Gogniat E, Villalba D, Ribero NV, Sartore M, Bosso M, Quiroga C, Leiva V, Scrigna M, Puchulu F, Distéfano E, Scapellato JL, Intile D, Planells F, Noval D, Buñirigo P, Jofré R, Nielsen ED (October 2013). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3891193">"Evaluation of tracheal cuff pressure variation in spontaneously breathing patients"</a>. <i>International Journal of Critical Illness and Injury Science</i>. <b>3</b> (4): <span class="nowrap">262–</span>8. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.4103%2F2229-5151.124148">10.4103/2229-5151.124148</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3891193">3891193</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24459624">24459624</a>.</cite><span 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class="Z3988"></span></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Tracheotomy&action=edit&section=18" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 0;text-align:center}@media(min-width:500px){.mw-parser-output .side-box-flex{display:flex;align-items:center}.mw-parser-output .side-box-text{flex:1;min-width:0}}@media(min-width:720px){.mw-parser-output .side-box{width:238px}.mw-parser-output .side-box-right{clear:right;float:right;margin-left:1em}.mw-parser-output .side-box-left{margin-right:1em}}</style><style data-mw-deduplicate="TemplateStyles:r1237033735">@media print{body.ns-0 .mw-parser-output .sistersitebox{display:none!important}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}</style><div class="side-box side-box-right plainlinks sistersitebox"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style> <div class="side-box-flex"> <div class="side-box-image"><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Wiktionary-logo-en-v2.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/9/99/Wiktionary-logo-en-v2.svg/40px-Wiktionary-logo-en-v2.svg.png" decoding="async" width="40" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/99/Wiktionary-logo-en-v2.svg/60px-Wiktionary-logo-en-v2.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/99/Wiktionary-logo-en-v2.svg/80px-Wiktionary-logo-en-v2.svg.png 2x" data-file-width="512" data-file-height="512" /></a></span></div> <div class="side-box-text plainlist">Look up <i><b><a href="https://en.wiktionary.org/wiki/tracheotomy" class="extiw" title="wiktionary:tracheotomy">tracheotomy</a></b></i>, <i><b><a href="https://en.wiktionary.org/wiki/pharyngotomy" class="extiw" title="wiktionary:pharyngotomy">pharyngotomy</a></b></i>, <i><b><a href="https://en.wiktionary.org/wiki/laryngotomy" class="extiw" title="wiktionary:laryngotomy">laryngotomy</a></b></i>, or <i><b><a href="https://en.wiktionary.org/wiki/tracheostomy" class="extiw" title="wiktionary:tracheostomy">tracheostomy</a></b></i> in Wiktionary, the free dictionary.</div></div> </div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1235681985"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1237033735"><div class="side-box side-box-right plainlinks sistersitebox"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"> <div class="side-box-flex"> <div class="side-box-image"><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Commons-logo.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/30px-Commons-logo.svg.png" decoding="async" width="30" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/45px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/59px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></a></span></div> <div class="side-box-text plainlist">Wikimedia Commons has media related to <span style="font-weight: bold; font-style: italic;"><a href="https://commons.wikimedia.org/wiki/Category:Tracheotomy" class="extiw" title="commons:Category:Tracheotomy">Tracheotomy</a></span>.</div></div> </div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239549316"><div class="refbegin" style=""> <ul><li><a rel="nofollow" class="external text" href="http://www.tracheotomy.info">Tracheotomy Info</a> (A community for tracheotomy-wearers and the people who love them) at tracheotomy.info</li> <li><a rel="nofollow" class="external text" href="http://www.trachs.com">Tracheostomy Products and Support</a> (Online resource for tracheostomy products, supplies and support) at trachs.com</li> <li><a rel="nofollow" class="external text" href="http://www.tracheostomy.com">Aaron's tracheostomy page</a> (Caring for a tracheostomy) at tracheostomy.com</li> <li><a rel="nofollow" class="external text" href="http://www.drtbalu.com/tracheostomy.html">(Pictures with video clipping)</a> at drtbalu.com</li> <li><a rel="nofollow" class="external text" href="http://www.translaryngealtracheostomyfantoni.it">Translaryngeal tracheostomy</a> <a rel="nofollow" class="external text" href="https://web.archive.org/web/20170911163221/http://translaryngealtracheostomyfantoni.it/">Archived</a> 11 September 2017 at the <a href="/wiki/Wayback_Machine" title="Wayback Machine">Wayback Machine</a></li> <li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20090628224336/http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/eight/000109880.htm">"Tracheotomy"</a> at <i><a href="/wiki/Dorland%27s_medical_reference_works" title="Dorland's medical reference works">Dorland's Medical Dictionary</a></i></li> <li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20091227151738/http://smiths-medical.com/education-resources/videos/airway/index.html">Smiths Medical Tracheostomy Training Videos</a></li> <li><a rel="nofollow" class="external text" href="https://www.youtube.com/watch?v=YE-n8cgl77Q">A Video of Rescue Breathing for Laryngectomees and Neck Breathers</a></li> <li><a rel="nofollow" class="external text" href="http://www.wdl.org/en/item/7385">"Book of Simplification Concerning Therapeutics and Diet"</a>, is a manuscript from 1497 that discusses tracheotomies</li> <li><a rel="nofollow" class="external text" href="https://www.tracheostomyeducation.com">An all inclusive resource about tracheostomy including articles and courses for medical professionals, caregivers and patients</a></li> <li><a rel="nofollow" class="external text" href="http://www.TrachResource.com">Site and blog with information about tracheostomies</a></li> <li><a rel="nofollow" class="external text" href="http://www.globaltrach.org">Global Tracheostomy Collaborative. International collaborative with resources for hospitals, caregivers, and patients about tracheostomies, including international research</a></li> <li><a rel="nofollow" class="external text" href="http://vts.uni-ulm.de/doc.asp?id=6821">Dilatational Tracheostomy On An Intensive Care Unit</a></li></ul> </div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul 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aria-labelledby="Tests_and_procedures_involving_the_respiratory_system89" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar 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style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><i><a href="/wiki/Human_nose" title="Human nose">nose</a></i></dt> <dd></dd> <dd><a href="/wiki/Rhinoplasty" title="Rhinoplasty">Rhinoplasty</a></dd> <dd><a href="/wiki/Septoplasty" title="Septoplasty">Septoplasty</a></dd> <dd><a href="/wiki/Somnoplasty" title="Somnoplasty">Somnoplasty</a></dd> <dd><a href="/wiki/Alarplasty" title="Alarplasty">Alarplasty</a></dd> <dd><a href="/wiki/Rhinectomy" title="Rhinectomy">Rhinectomy</a></dd> <dd><a href="/wiki/Rhinomanometry" title="Rhinomanometry">Rhinomanometry</a></dd> <dd><a href="/wiki/Acoustic_rhinometry" title="Acoustic rhinometry">Acoustic rhinometry</a></dd></dl> <dl><dt><i><a href="/wiki/Paranasal_sinuses" title="Paranasal sinuses">sinus</a></i></dt> <dd></dd> <dd><a href="/wiki/Sinusotomy" title="Sinusotomy">Sinusotomy</a></dd></dl> <dl><dt><i><a href="/wiki/Larynx" title="Larynx">larynx</a></i></dt> <dd></dd> <dd><a href="/wiki/Laryngoscopy" title="Laryngoscopy">Laryngoscopy</a></dd> <dd><a href="/wiki/Laryngectomy" title="Laryngectomy">Laryngectomy</a></dd> <dd><a href="/wiki/Laryngotomy" class="mw-redirect" title="Laryngotomy">Laryngotomy</a> <dl><dd><a href="/wiki/Thyrotomy" title="Thyrotomy">Thyrotomy</a></dd></dl></dd> <dd><a href="/wiki/Laryngotracheal_reconstruction" title="Laryngotracheal reconstruction">Laryngotracheal reconstruction</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Lower_respiratory_tract" class="mw-redirect" title="Lower respiratory tract">Lower RT</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><i><a href="/wiki/Vertebrate_trachea" class="mw-redirect" title="Vertebrate trachea">trachea</a></i></dt> <dd></dd> <dd><a href="/wiki/Cricothyrotomy" title="Cricothyrotomy">Cricothyrotomy</a></dd> <dd><a href="/wiki/Tracheo-oesophageal_puncture" class="mw-redirect" title="Tracheo-oesophageal puncture">Tracheoesophageal puncture</a></dd> <dd><a class="mw-selflink selflink">Tracheotomy</a></dd></dl> <dl><dt><i><a href="/wiki/Bronchus" title="Bronchus">bronchus</a></i></dt> <dd></dd> <dd><a href="/wiki/Bronchoscopy" title="Bronchoscopy">Bronchoscopy</a></dd></dl> <dl><dt><i><a href="/wiki/Human_lung" class="mw-redirect" title="Human lung">lung</a></i></dt> <dd></dd> <dd><a href="/wiki/Pneumonectomy" title="Pneumonectomy">Pneumonectomy</a></dd> <dd><a href="/wiki/Lobectomy" title="Lobectomy">Lobectomy</a></dd> <dd><a href="/wiki/Wedge_resection" title="Wedge resection">Wedge resection</a></dd> <dd><a href="/wiki/Lung_transplantation" title="Lung transplantation">Transplantation</a></dd> <dd><a href="/wiki/Decortication_of_lung" class="mw-redirect" title="Decortication of lung">Decortication</a></dd> <dd><a href="/wiki/Heart%E2%80%93lung_transplant" title="Heart–lung transplant">Heart–lung transplant</a></dd></dl> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Thoracic_wall" title="Thoracic wall">Chest wall</a>, <a href="/wiki/Pleura" title="Pleura">pleura</a>,<br /><a href="/wiki/Mediastinum" title="Mediastinum">mediastinum</a>,<br />and <a href="/wiki/Thoracic_diaphragm" title="Thoracic diaphragm">diaphragm</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <dl><dt><i><a href="/wiki/Pleura" title="Pleura">pleura</a>/<a href="/wiki/Pleural_cavity" title="Pleural cavity">pleural cavity</a></i></dt> <dd></dd> <dd><a href="/wiki/Thoracentesis" title="Thoracentesis">Thoracentesis</a></dd> <dd><a href="/wiki/Pleurodesis" title="Pleurodesis">Pleurodesis</a></dd> <dd><a href="/wiki/Thoracoscopy" title="Thoracoscopy">Thoracoscopy</a></dd> <dd><a href="/wiki/Thoracotomy" title="Thoracotomy">Thoracotomy</a></dd> <dd><a href="/wiki/Chest_tube" title="Chest tube">Chest tube</a></dd></dl> <dl><dt><i><a href="/wiki/Mediastinum" title="Mediastinum">mediastinum</a></i></dt> <dd></dd> <dd><a href="/wiki/Mediastinoscopy" title="Mediastinoscopy">Mediastinoscopy</a></dd></dl> <dl><dd><a href="/wiki/Nuss_procedure" title="Nuss procedure">Nuss procedure</a></dd></dl> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Tests</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Medical_imaging" title="Medical imaging">Medical imaging</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bronchography" title="Bronchography">Bronchography</a></li> <li><a href="/wiki/CT_pulmonary_angiogram" title="CT pulmonary angiogram">CT pulmonary 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