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What is Tracheostomy ?

A tracheostomy is a surgical procedure to create an opening (stoma) in the trachea through the neck, allowing direct access to the airway for breathing, typically by inserting a tracheostomy tube. It is performed to bypass an upper airway obstruction, facilitate long-term ventilation, or manage secretions in patients unable to protect their airway. In India, tracheostomy is conducted in critical care units, ENT departments, or trauma centers, offering high-quality care at affordable costs. For patients and families in India, understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for informed decision-making and optimal outcomes.

Why do you need Tracheostomy ?

Tracheostomy is indicated for:

  • Upper airway obstruction:
    • Trauma (e.g., facial fractures, laryngeal injury).
    • Tumors (e.g., laryngeal cancer).
    • Infections (e.g., epiglottitis, Ludwig’s angina).
  • Prolonged mechanical ventilation:
    • Patients requiring ventilation >10–14 days (e.g., ARDS, stroke, neuromuscular disease like ALS).
    • Reduces risk of laryngeal injury from prolonged endotracheal intubation.
  • Neurologic conditions:
    • Inability to protect airway (e.g., coma, severe stroke, Guillain-Barré syndrome).
    • Excessive secretions (e.g., in spinal cord injury).
  • Emergency airway management:
    • Failed intubation or severe facial trauma where oral/nasal intubation isn’t possible.

The procedure aims to secure the airway, improve ventilation, and facilitate weaning from mechanical ventilation. In India, hospitals like Apollo, Fortis, Medanta, and AIIMS specialize in tracheostomy, performed by ENT surgeons, critical care specialists, or general surgeons.

Why Do Tracheostomy Costs Vary in India?

Costs range from ₹30,000 to ₹2 lakh:

  • Procedure Type: Open tracheostomy (₹30,000–₹1 lakh), percutaneous (₹50,000–₹1.5 lakh), emergency (₹50,000–₹2 lakh).
  • Hospital/Location: Higher in metro cities (Apollo, Fortis); lower in government hospitals (AIIMS, ₹10,000–₹50,000).
  • Surgeon’s Expertise: Experienced ENT or critical care specialists charge more.
  • Additional Costs: ICU stay, bronchoscopy (for PDT), tracheostomy tubes (₹2,000–₹5,000 each), prolonged ventilation.
  • Insurance: Covered for emergencies or medical necessity; Ayushman Bharat offers subsidies.

Tracheostomy Procedure

The procedure can be elective or emergent, with two main approaches:

  1. Before Procedure Evaluation:
    • Assessment:
      • Clinical evaluation: Airway obstruction, respiratory distress, or ventilator dependence.
      • Imaging (e.g., CT neck) assesses anatomy (e.g., tumors, neck masses).
      • Blood tests ensure normal coagulation (e.g., INR, platelet count) to minimize bleeding risk.
    • Patients on ventilators are optimized (e.g., adequate oxygenation, sedation).
    • Consent is obtained, explaining risks and tracheostomy care.
  2. Surgical Techniques:
    • Open Tracheostomy:
      • Performed in the operating room or ICU under general anesthesia (or local anesthesia in emergencies), lasting 30–60 minutes.
      • The patient is positioned supine with the neck extended (a shoulder roll helps).
      • A 2–3 cm horizontal incision is made midway between the cricoid cartilage and sternal notch.
      • The strap muscles are separated, and the thyroid isthmus is retracted or divided.
      • A window is created in the trachea (typically between the 2nd and 3rd tracheal rings) using a vertical or horizontal incision.
      • A tracheostomy tube (size 6–8 for adults) is inserted, secured with sutures or a strap, and connected to a ventilator or oxygen if needed.
      • A chest X-ray confirms tube placement and rules out pneumothorax.
    • Percutaneous Dilational Tracheostomy (PDT):
      • Minimally invasive, often performed at the bedside in ICU under sedation (e.g., propofol, fentanyl), lasting 15–30 minutes.
      • Preferred for elective cases in ventilated patients.
      • A needle is inserted into the trachea under bronchoscopic guidance, followed by a guidewire.
      • Serial dilators (Seldinger technique) create the stoma, and the tracheostomy tube is inserted.
      • Less scarring, lower infection risk, but not suitable for emergencies or distorted anatomy (e.g., tumors).
    • Emergency Tracheostomy:
      • Rare, performed when cricothyrotomy (a simpler emergency airway procedure) isn’t feasible.
      • Done under local anesthesia with minimal preparation; higher complication risk.
  3. After Procedure:
    • Patients are monitored in the ICU or ward for 1–5 days.
    • The tracheostomy tube is checked for patency; suctioning removes mucus or blood.
    • Pain is managed with analgesics (e.g., paracetamol).
    • Speech therapy (if awake) helps with communication (e.g., speaking valves).
    • The first tube change occurs after 5–7 days (to allow tract formation), then weekly or as needed.

Recovery After Tracheostomy

  1. Hospital Stay: 1–5 days for the procedure; longer if on prolonged ventilation (weeks to months).
  2. Post-Procedure Care:
    • Pain at the site for 3–5 days, managed with analgesics.
    • Regular suctioning (every 4–6 hours initially) keeps the tube clear of mucus.
    • Humidified air prevents drying of secretions; saline nebulization may be used.
    • Inner cannula (if present) is cleaned daily; the outer tube is changed weekly.
    • Patients/families are trained on tracheostomy care (e.g., suctioning, cleaning) before discharge.
  3. Activity/Diet:
    • Light activities (e.g., sitting, walking) in 1–2 days; strenuous activities avoided until decannulation (tube removal).
    • Swallowing may be impaired initially; a speech therapist assesses risk of aspiration.
    • Diet: Liquids to soft foods, often via feeding tube (e.g., nasogastric) if aspiration risk is high.
  4. Follow-Up:
    • Weekly visits to monitor the stoma and tube; ENT evaluation for decannulation readiness.
    • Decannulation (tube removal): Once the underlying condition resolves (e.g., airway obstruction cleared, ventilator weaned), typically 2 weeks to months.

Most resume normal activities in 2–4 weeks (if not ventilator-dependent). Success rates are >95% for securing the airway; long-term outcomes depend on the underlying condition (e.g., cancer, neurologic recovery).

Risks and Complications

  • Immediate Risks: Bleeding (1–3%, higher in PDT), pneumothorax (1–2%), tube dislodgement (1–5%), false tract creation.
  • Early Complications: Infection (stomal cellulitis, 3–5%), obstruction (mucus plugging, requiring suctioning), accidental decannulation.
  • Late Complications: Tracheal stenosis (1–5%), tracheomalacia, granulation tissue, tracheoesophageal fistula (rare).
  • General Risks: Anesthesia reactions, subcutaneous emphysema.

Report fever, difficulty breathing, or excessive bleeding promptly.

Frequently Asked Questions (FAQs)

What causes the need for tracheostomy?

Upper airway obstruction, prolonged ventilation, or inability to protect the airway (e.g., coma, neurologic disease).

Is tracheostomy permanent?

Not always; temporary in many cases (e.g., trauma, ventilation), permanent if the underlying condition persists (e.g., laryngeal cancer).

Can I speak with a tracheostomy?

Yes, with a speaking valve (e.g., Passy-Muir) or fenestrated tube, once stable; speech therapy helps.

How soon can I resume activities?

Light activities in 1–2 days; normal routines in 2–4 weeks (if not ventilator-dependent).

Is tracheostomy covered by insurance in India?

Yes, for emergencies or medical necessity; confirm with your provider.

Signs of complications?

Fever, difficulty breathing, bleeding, or tube blockage.

Can I eat normally with a tracheostomy?

Swallowing may be challenging initially; a feeding tube may be used until safe to eat, guided by a swallow assessment.

Lifestyle changes post-tracheostomy?

Tracheostomy care (suctioning, cleaning), avoid swimming (risk of water entering stoma), speech/swallowing therapy, regular follow-ups.

Conclusion

Tracheostomy is a critical procedure to secure the airway in life-threatening or chronic conditions, with high success rates and manageable recovery. India’s top hospitals (Apollo, Fortis, AIIMS) offer affordable, expert care. Understanding the procedure, costs, recovery, risks, and FAQs helps patients and families approach tracheostomy confidently. Consult an ENT surgeon or critical care specialist for personalized guidance and successful management.

Looking for Best Hospitals for Tracheostomy

Note: we are not promoting any hospitals

we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)

  • click on your city and schedule your surgery now done in good hands.
City Minimum Price (₹) Maximum Price (₹)
Agra
30,000
80,000
Ahmedabad
50,000
1,00,000
Ajmer
30,000
80,000
Aligarh
30,000
80,000
Allahabad
30,000
80,000
Amritsar
40,000
90,000
Aurangabad
40,000
90,000
Bangalore
50,000
1,00,000
Bareilly
30,000
80,000
Belgaum
40,000
90,000
Bhopal
40,000
90,000
Bhubaneswar
40,000
90,000
Bikaner
30,000
80,000
Chandigarh
50,000
1,00,000
Chennai
50,000
1,00,000
Coimbatore
50,000
1,00,000
Dehradun
40,000
90,000
Delhi
50,000
1,00,000
Dhanbad
30,000
80,000
Durgapur
30,000
80,000
Faridabad
50,000
1,00,000
Ghaziabad
50,000
1,00,000
Gorakhpur
30,000
80,000
Guntur
40,000
90,000
Gurgaon
50,000
1,00,000
Guwahati
40,000
90,000
Gwalior
30,000
80,000
Hyderabad
50,000
1,00,000
Indore
40,000
90,000
Jabalpur
30,000
80,000
Jaipur
50,000
1,00,000
Jalandhar
40,000
90,000
Jamshedpur
40,000
90,000
Jodhpur
30,000
80,000
Kanpur
30,000
80,000
Kochi
50,000
1,00,000
Kolkata
50,000
1,00,000
Kollam
40,000
90,000
Lucknow
40,000
90,000
Ludhiana
50,000
1,00,000
Madurai
40,000
90,000
Mangalore
40,000
90,000
Meerut
30,000
80,000
Moradabad
30,000
80,000
Mumbai
50,000
1,00,000
Mysore
50,000
1,00,000
Nagpur
40,000
90,000
Nashik
40,000
90,000
Navi Mumbai
50,000
1,00,000
Noida
50,000
1,00,000
Patna
30,000
80,000
Pune
50,000
1,00,000
Raipur
40,000
90,000
Rajkot
40,000
90,000
Ranchi
30,000
80,000
Surat
50,000
1,00,000
Thane
50,000
1,00,000
Vadodara
40,000
90,000
Varanasi
30,000
80,000
Visakhapatnam
40,000
90,000

Disclaimer

This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.

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