Tracheostomy in Sharjah

What is a tracheostomy?

A tracheostomy is a surgical opening in the front of the windpipe, below the voice box, with a curved tube placed in it to create a new route for breathing. The opening itself is called a stoma. Air then enters the lungs through the tube in the neck, bypassing the nose, mouth and throat above.

Surgeons distinguish two situations. A planned tracheostomy is scheduled in advance, for example for someone on a ventilator in intensive care or before major surgery on the head and neck. An emergency tracheostomy is performed urgently when the upper airway is blocked and breathing is at risk.

A point many families find surprising: most tracheostomies are temporary. Once the reason for the tube has passed, the tube is removed and the opening usually closes on its own, leaving a small scar. At Dar Al Kamal Hospital, Sharjah, the ENT surgeon performs the operation, and the daily nursing care of the tube that follows is described on the tracheostomy care page.

Who needs it

A tracheostomy is considered when the airway above the windpipe is blocked or at risk, or when breathing support is expected to last a long time. Common reasons include:

• A long period on a ventilator in intensive care, where a neck tube is more comfortable than a tube through the mouth and helps weaning
• Swelling, infection or injury in the throat, mouth or voice box that narrows the airway
• Weakness or paralysis of both vocal cords, which can close the gap between them
• A tumour in the throat or voice box pressing on the airway
• Major surgery on the mouth, throat or neck, such as a neck dissection with other surgery, where swelling afterwards could narrow the airway
• Difficulty clearing secretions from the chest after a long illness

In intensive care, the tube is sometimes placed at the bedside by the critical care team using a needle-and-dilator method. A surgical tracheostomy in theatre by the ENT surgeon is preferred when the neck anatomy is complex, the airway is narrowed, or the neck has had previous surgery or radiotherapy. Alternatives depend on the cause and include continuing with a mouth tube for a short while longer, treating swelling with medicines, or other forms of airway management. The surgeon and the treating team explain the reasons and discuss them with the patient or family first.

What happens

A planned tracheostomy is usually performed in theatre under general anaesthesia. When the airway above is too narrow for a breathing tube, the surgeon may perform the operation under local anaesthetic with the patient awake and breathing on their own, which keeps the airway safe throughout.

You lie on your back with a small roll under the shoulders so the neck extends. The surgeon makes a short horizontal incision in the lower neck, between the Adam's apple and the top of the breastbone, and gently separates the neck muscles. The narrow middle part of the thyroid gland, which lies across the windpipe, is moved aside or divided. A small window is then opened in the front wall of the windpipe and the tracheostomy tube is passed in as the anaesthetist withdraws any mouth tube. The tube is secured with stitches and a soft neck tie.

In an emergency, the same steps are carried out quickly by the surgeon, often under local anaesthetic, with the emergency and anaesthetic teams supporting breathing throughout. The first change of the tube is carried out by the team after some days, once the track through the neck has formed.

Preparing for it

For a planned operation, the surgeon explains the reasons, the steps and the plan for speech and swallowing, and asks for consent from the patient or, where the patient is too unwell, discusses it with the family. Blood tests check clotting, and blood thinners are paused on the team's advice. Fasting follows the anaesthetist's instructions.

Families can help by naming one contact person, sharing a list of medicines and allergies, and bringing a pen and notepad or a phone with large text. These let the patient communicate before speech returns. Tell the team about language, prayer and cultural needs so they are respected.

Afterwards

In the first days, nurses clear secretions through the tube with gentle suction, humidify the air, and keep the skin around the stoma clean. Coughing into the tube is normal. Speech is possible once the team fits a one-way speaking valve or lets the cuff down, and swallowing is checked before food restarts, with speech and swallowing therapists joining the care where needed. These steps are described in detail on the tracheostomy care page.

When the original problem has settled, the tube is changed to a smaller size, capped for trial periods, and then removed. This is called decannulation. A dressing covers the opening while it heals, and the voice grows stronger with use. A few people go home with a tracheostomy, and the family is trained in its care before discharge.

If the tube comes out or seems blocked and breathing becomes difficult, call for help immediately: use the nurse call in hospital, or call emergency services at home. Contact the hospital on 06 599 7777 for bleeding around the tube, redness or discharge at the stoma, or a fever.

Cost and insurance

Most UAE insurance plans cover tracheostomy when it is medically needed. An emergency tracheostomy proceeds without waiting for approval, while planned operations usually need pre-approval, often as part of the wider admission. Home suction equipment and tube supplies are covered differently between plans. Dar Al Kamal Hospital, Sharjah can help you confirm your cover on 06 599 7777.