[Permanent tracheotomy in respiratory insufficiency]

Assisted ventilation at home for breathing insufficiencies requires long-term tracheotomy. Standard tracheotomy is frequently complicated by granuloma and tracheostomy stenosis. We have designed a permanent opening technique that we report on 9 patients. The technique prevents, as far as possible, granuloma and stenosis formation and provides a sufficiently large opening to reduce irritation during tracheotomy tube change. Surgery must be done under general anesthesia. High-dose long-term corticosteroid treatment can induce skin breakdown.