TRACHEOTOMY is the operation of cutting into the trachea. It is sometimes also called Bronchotomy ; and a similar operation on the lower part of the larynx is named Laryngotomy. The anatomy of the parts principally concerned in these operations will be found in the articles LARYNX and RESPIRATION, in NAT. I IIST.
Tracheotomy may be performed for several purposes; as, to form an aperture either for the admission of air into the lungs, when the larynx, fences, or upper parts of the air-passages aro obstructed, or for the extraction of foreign bodies from the adjacent parts of the air-passages, or for the facility of inflating the lungs in suspended animation. In the first view it may be necessary in many diseases ; such as croup, acute laryngitis, oedema of the glottis, severe cases of quinsy, tumours, and other growths in the larynx or pressing on it, and diphtheria ; in all of which the aperture through the glottis is frequently closed, not merely by the swelling of the membranes around it, or the enlargement of the adjacent parts, but by the apasmedic and fixed contraction of the muscles whose office it is to approximate the vocal ligaments. The relief afforded by the operation is often instantaneous, and, for a timo, complete ; but its ultimate results aro less certain, for though it may be sufficient to prevent the impending suffocation, it has no influence in arresting the original disease. On the contrary, the operation itself is not without danger ; and that, both from the accidents that may occur in its performance, and from its subsequent effects ; and therefore, although no general rule can be laid down, its performance should not be undertaken unadvisedly, nor in any cases in which it is not abet).
lutely and almost immediately necessary for the preservation of life.
In its performance a vertical incision is first made in the median line of the throat, either below the thyroid gland, or more or less above it, according to the circumstances of tho ease and the object to bo ROOM]. illiShOd. The dissection must then be continued carefully onwards in the same direction, pushing aside the aterno-hyoid muscles, and what ever vessels lie in or near the middle line, till the trachea is completely exposed. When the hemorrhage has ceased, or is but slight, the trachea must be opened, first by a vertical incision, and then by removing portions of one or more of its rings, according to the size of the aperture that Is required. Through the opening a short silver canals mast be Introduced, and, as often as is rendered necessary by mucus accumulating in it, must be removed, cleaned, and again intro duced. The means to be subsequently adopted must very with the circumstances of each ease : if the obstruction is removed, the wound in the trachea may be healed, but if not, the canula must be worn for the rest of life. If the operation were performed for the removal of a foreign body, or for the inflation of the lungs, no canula need be intro duced, but the wound should be closed as soon as the main object is