What is tracheal surgery?

Tracheal surgery treats a variety of diseases, disorders and conditions that affect the function of the trachea (windpipe). This includes airway blockages, cancerous and noncancerous tumors, and problems with the larynx (voice box). Tracheal surgery can restore breathing function and improve quality of life for people with common or rare tracheal conditions.

Your trachea, or windpipe, starts in the neck just below the voice box and continues down behind the breastbone. It divides into two smaller tubes called bronchi the supply air to each lung. Your trachea is made of muscle, connective tissue, and rings of stiff cartilage. It also has a lining of moist mucus membranes. Your trachea expands and contracts slightly as you breathe. 

Tracheal surgery is major surgery that has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having tracheal surgery. 

Types of tracheal surgery

The types of tracheal surgery include: 

  • Laryngotracheal reconstruction rebuilds and widens the windpipe using pieces of cartilage from another area or from a donor.
  • Laryngotracheal resection and reanastomosis removes a section of the windpipe and joins the two ends.
  • Tracheostomy creates a stoma (hole) in the front of the neck and through the trachea (windpipe). A tube is inserted in the opening. The tube provides an airway for breathing and a way to remove lung secretions and excess mucus.

Why is tracheal surgery performed?

Your doctor may recommend tracheal surgery to treat a disease, disorder or condition that affects the function of the trachea (windpipe). Tracheal is not a common surgery. Your doctor will only consider tracheal if less invasive treatments are ineffective. Ask your doctor about all of your treatment options and consider getting a second opinion. 

Your doctor may recommend tracheal surgery to treat: 

  • Fistulas, or abnormal connections between the esophagus and windpipe
  • Stenosis, or narrowing of the windpipe
  • Subglottic stenosis, or narrowing of the area directly below the voice box
  • Tumors, including both cancerous and noncancerous growths 

Who performs tracheal surgery?

Thoracic surgeons and otolaryngologists (pronounced “ōtō-lar-en-gäl-e-jests”) perform tracheal surgery. Thoracic surgeons specialize in the surgical treatment of diseases of the chest, including the blood vessels, heart, lungs, and esophagus. Thoracic surgeons may also be known as cardiothoracic surgeons. Otolaryngologists specialize in the medical and surgical care of the ears, nose and throat, and conditions affecting the head and neck. Otolaryngologists may also be known as ear, nose and throat (ENT) doctors.

How is tracheal surgery performed?

You tracheal surgery will be performed in a hospital. Your surgeon can use either an open surgery method or a minimally invasive method for your tracheal surgery.

Surgical approaches to tracheal surgery

Your surgeon will perform your tracheal surgery using one of the following approaches:

  • Minimally invasive surgery involves inserting special instruments and an endoscope through at least two small incisions in your neck or chest. The endoscope is a thin, lighted instrument with a small camera. The camera transmits pictures of your trachea to a video screen. Your surgeon sees your trachea on the screen while performing surgery. Minimally invasive surgery generally involves a faster recovery and less pain than open surgery. This is because it causes less trauma to tissues and organs. Your doctor will make small incisions instead of a larger one used in open surgery. Surgical tools are threaded around muscles and tissues instead of cutting through or displacing them as in open surgery. Your doctor may also use a laser to assist in performing minimally invasive surgery.
  • Open surgery involves making a large incision in the front of your neck or chest. The incision may include your breastbone if the surgical site is in the lower trachea. Open surgery allows your doctor to directly see and access the surgical area. Open surgery generally involves a longer recovery and more pain than minimally invasive surgery. Open surgery requires a larger incision and more cutting and displacement of muscle and other tissues than minimally invasive surgery. Despite this, open surgery may be a safer or more effective method for certain patients.