History of the tracheotomy

Feb 27 2005

The tracheotomy, performed on Pope John Paul II, is an incision made into the windpipe, or trachea, through the front of a person’s neck.

When a person’s upper airway is blocked, an otolaryngologist-head and neck surgeon (ear, nose, and throat specialist) can perform a tracheotomy to create an alternate airway. Air can then be drawn into the lungs via an opening in the trachea, bypassing foreign bodies, secretions, or swelling. This opening may be temporary or permanent, depending on the needs of the individual patient.

Over time, the tracheotomy has gone by several different names, among them pharyngotomy, laryngotomy, bronchotomy, tracheostomy, and tracheotomy. The word tracheotomy first appeared in print in 1649, but was not commonly used until a century later. Tracheostomy refers specifically to the opening, or stoma, created by the tracheotomy procedure. Sometimes this term is used interchangeably with tracheotomy to refer to the operation itself.

The earliest known depiction of a tracheotomy is found on Egyptian tablets dating back to circa 3600 B.C.E., during the First Dynasty. However, it was not readily accepted. Coelius Aurelianus, writing in the fifth century C.E., refers to it as “a fantastic operation” and “a futile and irresponsible idea.” Thus, it wasn’t until the Renaissance, when interest in scientific study increased, that surgeons grew more open-minded about experimenting with surgery on the trachea and performed tracheotomies for a variety of reasons.

Otolaryngologist—head and neck surgeons perform two of every three tracheotomies done in the United States. In most medical schools, a member of this specialty will teach the physician-in-training how to carry out this emergency procedure.

A more detailed history of the tracheotomy can be found by visiting in the John Q. Adams Center for the History of Otolaryngology-Head and Neck Surgery located adjacent to the American Academy of Otolaryngology—Head and Neck Surgery headquarters in Alexandria, VA, or see the tracheotomy exhibit at http://www.entnet.org.