Editing Tracheal intubation (section)

===Tracheotomy===
{{Main|Tracheotomy}}
[[Image:Traqueostomia.png|thumb|left|alt=Diagram of a tracheostomy tube in the trachea|Diagram of a [[tracheal tube|tracheostomy tube]] in the trachea:<br>
1 - [[Vocal folds]]<br>
2 - [[Thyroid cartilage]]<br>
3 - [[Cricoid cartilage]]<br>
4 - [[Tracheal rings]]<br>
5 - Balloon cuff]]

Tracheotomy consists of making an incision on the front of the neck and opening a direct airway through an incision in the trachea. The resulting [[Stoma (medicine)|opening]] can serve independently as an airway or as a site for a tracheostomy tube to be inserted; this tube allows a person to breathe without the use of his nose or mouth. The opening may be made by a scalpel or a needle (referred to as surgical<ref name=Gibbs2007/> and percutaneous<ref name=Anon2000/> techniques respectively) and both techniques are widely used in current practice. In order to limit the risk of damage to the [[recurrent laryngeal nerve]]s (the nerves that control the [[vocal folds|voice box]]), the tracheotomy is performed as high in the trachea as possible. If only one of these nerves is damaged, the patient's voice may be impaired ([[dysphonia]]); if both of the nerves are damaged, the patient will be unable to speak ([[aphonia]]). In the acute setting, indications for tracheotomy are similar to those for cricothyrotomy. In the chronic setting, indications for tracheotomy include the need for long-term mechanical ventilation and removal of tracheal secretions (e.g., comatose patients, or extensive surgery involving the head and neck).<ref name=Heffner1989/><ref name=Lee2002/>