# Tracheotome > Mediated Wiki article. Canonical URL: https://mediated.wiki/source/Tracheotome > Markdown URL: https://mediated.wiki/source/Tracheotome.md > Source: https://en.wikipedia.org/wiki/Tracheotome > Source revision: 1345360459 > License: Creative Commons Attribution-ShareAlike 4.0 International (https://creativecommons.org/licenses/by-sa/4.0/) A **tracheotome** is a [medical instrument](/source/Medical_instrument) used to perform an incision in the [trachea](/source/Vertebrate_trachea) with a cutting blade operated by a powered cannula. It is often called a tracheostomy tube because once it enters the [stoma](/source/Stoma_(medicine)) in the trachea, a [breathing tube](/source/Tracheal_tube) is connected to a ventilator and oxygen is provided to the lungs. There are different types of tracheotomes. They can be made of [metal](/source/Metal), [plastic](/source/Plastic) or [silicone](/source/Silicone). Plastic and silicone are widely used since they reduce the complications from the tracheotomy procedure such as [subglottic stenosis](/source/Subglottic_stenosis) and erosion of large [blood vessels](/source/Blood_vessel).[1] ## History The tracheostomy procedure is an ancient medical procedure which dates back to 2000 BC.[2] There are some records of physicians performing [tracheostomy](/source/Tracheostomy) to save the lives of children and sick people from choking.[1] However, several complications were also common after the procedure was performed due to the severity of the infections and other diseases causing the oxygen obstruction. It was not until the mid-1900s that this medical tool was improved. The introduction of the mechanized tracheotome illustrates how the procedure and the device were improved. The introduction of the mechanized tracheotome by Joseph John Amato in 1972, [North Riverside](/source/North_Riverside), provided a quicker, cleaner and precise cut which reduced the possibility of tissue damage and infection.[3] Previous procedures for [tracheotomy](/source/Tracheotomy) were being implemented at the time, but many would lead to severe complications and were difficult to operate. Most of them required special skills and well trained practitioners. ## Types of tracheotomes ### Mechanized tracheotome The mechanized tracheotome consisted of a [staple](/source/Surgical_staple), cutting blade, specialized plunger and a motor unit. Once the staple was fixed to the neck of the patient, the blade moved forward the skin, [fascia](/source/Fascia) and trachea to perform the incision.[3] Then, a plunger moved forward and then backward to hold the tissues .[3] Later, the tracheotome was removed from the patient and only the staple remained in the neck to maintain the trachea open. These were the innovative features of the mechanized tracheotome which were different from the tracheotomes at the time. It was either spring or gas-powered operated.[3] ### Spring operated tracheotome Other tracheotomes such as the spring operated tracheotome designed by Adamson Howard in 1985, [Florida](/source/Florida), improved the design by reducing the size and including a rotatable adjustable cap at the mount of the tracheotome to control the depth of penetration in the incision. Its handle also allowed the recocking of the spring operated cutting blade.[4] ### Other adaptations Leslie William Peterson also made significant contributions to the improvement of the tracheostome. In 2006, his tracheal tube/catheter adaptor cap was introduced and consisted in a cap with two separate projections that allowed the [catheter](/source/Catheter) to be in position and prevent their rotation. It also provided heated and/or humidified gas to patients dependent on the breathing machine.[5] Once the incisions are made by the tracheotome and the [stomas](/source/Stoma_(medicine)) are accessible, tracheotome tubes are placed in the trachea to provide oxygen to the lungs. Tubes have also been improved to reduce complications of infection and tissue damage. For instance, Alain Milhay from [Amiens](/source/Amiens), [France](/source/France), invented a tracheotomy tube with shield for [anesthesia](/source/Anesthesia) in 1983. This tube included a conduit for passing on anesthesia and [ventilation](/source/Ventilation_(physiology)) gases. At the time, other tubes were also implemented for anesthesia application but their material composition was toxic and could give off caustic or [toxic](/source/Toxic) vapors.[6] ## Advantages Tracheotomes became very inexpensive medical tools and easy devices to operate. The use of tracheotomes provides immediate oxygen supplies to patients by bypassing obstructions in the upper airway.[7] Tracheotomes provide another alternative for airflow when there are [glottic](/source/Glottic) pathological conditions such as [neoplasm](/source/Neoplasm) and bilateral vocal cord paralysis.[2] Also, air obstruction due to neck trauma and facial fracture can be alleviated with the tracheotome incision and oxygen supply. ## Complications Patients may develop different complications after the incision is made with the tracheotome. Although these may be rare, bleeding, air obstruction, damage to the [larynx](/source/Larynx), change of voice, infection, impaired swallowing and permanent scars may occur.[7] This is why the procedure is only performed in case of emergency.[7] Vessels such as the [carotid arteries](/source/Carotid_arteries) or [internal jugular veins](/source/Internal_jugular_veins) could also be damaged if the incision and penetration of the blade is not accurate, with a higher risk in children and obese patients.[2] ## Tracheotome tubes used in conjunction with tracheotomes - Single Cannula Silicone Tube - Tube with inner cannula - Metal tube with inner cannula and obturator - Fenestrated tubes - Montgomery T-tubes ## See also - [Instruments used in general surgery](/source/Instruments_used_in_general_surgery) ## References 1. [Types of Tracheostomy Tubes](http://www.tracheostomy.com/faq/types.htm). Aaron's Tracheostomy Page. 2004. Retrieved November 22, 2009. 1. Lindman, Jonathan. 2009. [Tracheostomy](http://emedicine.medscape.com/article/865068-overview). Department of Otolaryngology, ENT Care Associates. 1. [Amato, Joseph. 1969. [Mechanized Tracheotome](http://www.wikipatents.com/3643649.html-5)[dead link]. North Riverside, Illinois. 1. [Howard, Adamson. 1985. [Spring Operated Tracheotome](http://www.patentstorm.us/patents/4556059/fulltext.html) [Archived](https://web.archive.org/web/20110612224411/http://www.patentstorm.us/patents/4556059/fulltext.html) 2011-06-12 at the Wayback Machine. Margate, Florida. 1. [Peterson, Leslie. 2006. [Tracheal Tube/Tracheal Catheter Adaptor Cap](http://www.patentstorm.us/applications/20060070627/fulltext.html) [Archived](https://web.archive.org/web/20110612224544/http://www.patentstorm.us/applications/20060070627/fulltext.html) 2011-06-12 at the Wayback Machine. Castle Rock, CO. 1. [Milhay, Alain. 1983. [Tracheotomy Tube with Shield for Anesthesia](http://www.patentstorm.us/patents/4378796/fulltext.html) [Archived](https://web.archive.org/web/20110612224535/http://www.patentstorm.us/patents/4378796/fulltext.html) 2011-06-12 at the Wayback Machine. Amiens, France. 1. [Tracheostomy](http://www.medicinenet.com/tracheostomy/article.htm), Balentine, Jerry. Medicine Net. Retrieved November 22, 2009. --- Adapted from the Wikipedia article [Tracheotome](https://en.wikipedia.org/wiki/Tracheotome) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Tracheotome?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.