(tracheo-) combining form denoting the trachea.
Reasons for operation The cause of laryngeal obstruction should be treated but, if obstruction is acute and endangering the patient’s life, urgent intervention is necessary. In most cases the insertion of an endotracheal tube either through the nose or mouth and down the pharynx through the larynx to bypass the obstruction is e?ective (see ENDOTRACHEAL INTUBATION). If not, tracheostomy is performed. The majority of tracheostomies performed nowadays are for patients in intensive-therapy-unit situations. These patients require airway intervention for prolonged periods to facilitate arti?cial ventilation which is performed by means of a mechanical ventilator. The presence of a tube passing through the larynx for a prolonged period of time is associated with long-term damage to the larynx, and therefore any patients requiring prolonged intubation usually undergo a tracheostomy to prevent further damage. Endotracheal intubation is also the preferred method of airway-intervention for acute in?ammatory disorders of the upper airway (as opposed to tracheostomy); tracheostomy in these cases is performed only in the emergency situation if facilities for endotracheal intubation are not available or if they are unsuccessful. Tracheostomy may also be performed for large tumours which obstruct the larynx until some form of treatment is instituted. Similarly it may be needed in conditions whereby the nerve supply to the larynx has been jeopardised, impairing its protective function of the upper airway and its respiratory function.
Tracheostomy tubes When the trachea has been opened – by an incision through the skin between the Adam’s apple and the clavicles; another through the THYROID GLAND followed by a small vertical incision in the trachea
– a metal or plastic tube is inserted to maintain the opening. There is always an outer tube which is ?xed in position by tapes passing round the neck, and an inner tube which slides freely out of and into the other, so that it may be removed at any time for cleansing, and is readily coughed-out should it happen to become blocked by mucus.
After-treatment When the operation has been performed for some permanent obstruction, the tube must be worn permanently; and the double metal tube is in such cases replaced after a short time by a soft plastic single one. When the operation has relieved some obstruction caused, say, by diphtheria, the tube is left out now and then for a few hours, and ?nally, at the end of a week or so, is removed altogether, after which the wound quickly heals up.... tracheostomy
Habitat: Temperate and subtropical Himalaya from Kumaon to Arunachal Pradesh and in Assam, Meghalaya up to 2,100 m.
Folk: Duudhi (Kumaon), Akhaahi- lataa (Assam).Action: Used as a substitute for Alstonia scholaris.
T. jasminoides Lem. (Star-Jasmine), native to China and Japan, is cultivated all over India. Alkaline extracts of the leaf and stem show activity against yeast. The leaves and twigs contain dambonitol, cyclitol, arctiin, tracheloside, beta-amyrin and its acetate, lu- peol acetate, and a mixture of beta- stosterol, stigmasterol and campes- terol. A flavone glycoside was isolated from the butanol extract of dried leaves and several indole alkaloids from the alcoholic extract of dried leaves and twigs.The leaves, stem and twigs are used for treating rheumatic arthritis, nervous disorders, urine retention and as a tonic for weak muscles or nerves.... trachelospermum fragransThe condition is often discovered soon after birth; diagnosis may be confirmed by X-rays.
Treatment consists of an operation to close the fistula and connect the trachea and oesophagus correctly.... tracheoesophageal fistula
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