A tracheostomy is usually done for one of three reasons: (1) to more easily, and usually more safely, deliver oxygen to the lungs; (2) to clean and remove secretions from the airway; and (3) to bypass an obstructed upper airway. All tracheostomies are performed due to a lack of air getting to the lungs. There are many reasons why sufficient air cannot get to the lungs. Airway Problems That May Require a Tracheostomy - Tumors, such as Cystic Hygroma
- Infection, such as Epiglottitis supraglotitis
- Bilateral vocal cord paralyses
- Severe obstructive sleep apnea
- Injury to larynx (voicebox) or mouth
- Foreign body obstruction of the air passage above the voice box
Lung Problems That May Require a Tracheostomy - Need for prolonged respiratory support (Most common indication at present)
- Chronic pulmonary disease to reduce anatomic dead space
- Chest wall injury
- Diaphragm dysfunction
Other Reasons for a Tracheostomy - Long-term unconsciousness or coma due to head/brain injury
- Neuromuscular diseases paralyzing or weakening chest muscles and diaphragm
- Aspiration related to muscle or sensory problems in the throat
- Fracture of cervical vertebrae with spinal cord injury
- Disorders of respiratory control such as Congenital Central Hypoventilation or Central Apnea
- Facial surgery and facial burns
- Anaphylaxis (severe allergic reaction)
Tracheostomy Questions? E-mail tracheostomysupport@jhmi.edu | 
