WHY YOU CAN’T STAY AWAKE: MANAGEMENT OF APNEA – TRACHEOSTOMY
In this surgery, an opening is made in the trachea to permit the insertion of a breathing tube which bypasses the obstructed segment of the airway. This approach is considered the “gold standard” against which the effectiveness of other treatments is often measured, especially in cases complicated by life-threatening arrhythmias (irregular heart rhythms). Again, however, there are disadvantages. The tracheostomy tube is permanent; it must be carefully cleaned and maintained, posing hygiene problems. Patients often feel a sense of disapproval from society, including friends, relatives, and co-workers who are uncomfortable in the presence of such a device. Obese patients—a significant proportion of apneics—may experience some mechanical difficulty, especially if their necks are particularly fleshy or layered. The recent trend in medicine is to reserve tracheostomy for only the most serious cases; otherwise, it is often difficult to justify its use.*147\226\8*
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