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Tracheostomy - a temporary airway, planned properly.

A small opening in the front of the neck into the trachea, holding a soft plastic tube. Percutaneous at the bedside or open in theatre - with a weaning, speech and decannulation plan mapped out before the tube goes in.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private tracheostomy costs in the UK.

Indicative ranges across our partner ICUs and ENT theatres.

In short

£3,500–£6,500, done at the bedside in 20–40 minutes.

Procedure Indicative range
Percutaneous tracheostomy (bedside, ICU) £3,500–£6,500
Surgical open tracheostomy (theatre) £5,500–£9,500
Paediatric tracheostomy £8,000–£14,000
Permanent (end) tracheostomy after laryngectomy Included in laryngectomy fee
Tracheostomy tube change under sedation £1,200–£2,400
Decannulation review and speech clinic £350–£600
ENT consultation only £250–£450

Prices vary by hospital, by the surgeon and by whether the tracheostomy is done at the bedside or in theatre. ICU stay, tubes and follow-up are usually itemised separately.

The problem

The right technique, the right timing, and the plan to come off it.

Tracheostomy is where good ICU sometimes slips - timing left drifting, weaning left to chance, speech and swallow left too late. We fix all three before the tube goes in.

  • Is the timing right?

    Placing at day 7–10 of ventilation reduces sedation and shortens ICU. Waiting past day 21 rarely helps and often harms.

  • Is percutaneous safe here?

    A short, thick neck, prior radiotherapy, coagulopathy or a paediatric airway pushes the case into theatre for a formal open procedure.

  • What does decannulation look like?

    Cuff deflation, speaking valve, downsizing, capping - the milestones and dates are on the plan from day one.

When it helps

When tracheostomy is the right step.

The situations we see most, plus the one emergency that means an airway team at the bedside, right now.

  • Prolonged mechanical ventilation

    When more than 7–14 days on the ventilator is likely, tracheostomy reduces sedation, improves comfort and speeds weaning.

  • Upper airway obstruction

    Tumour, trauma, deep neck infection or bilateral vocal cord palsy blocking the larynx - a stoma bypasses the block.

  • Failed extubation

    Two or more failed extubations, or a weak cough that cannot clear secretions - a tracheostomy is the safer route.

  • Neurological weakness

    Stroke, spinal cord injury, motor neurone disease, Guillain–Barré - long-term airway protection and secretion control.

  • Head and neck surgery airway cover

    Elective cover for major oral, oropharyngeal or laryngeal surgery where swelling would threaten the airway afterwards.

  • Chronic aspiration

    Unsafe swallow with recurrent chest infections - a cuffed tracheostomy protects the lungs while a longer-term plan is made.

  • Sleep apnoea (last-resort)

    Very rarely, severe obstructive sleep apnoea unresponsive to CPAP, surgery and hypoglossal stimulation - considered only at specialist centres.

  • Red flag: displaced or blocked tube

    A recently placed tube that comes out or blocks is an airway emergency. Follow the bedside algorithm, call 2222, and never force a new tube into a fresh stoma.

Procedure options

Technique and tube both depend on the airway you have.

What each option involves - bedside percutaneous, formal open, mini-tracheostomy, and the tube choices that make speech and weaning possible.

  • Percutaneous dilational

    The workhorse in ICU. Bedside, under sedation and bronchoscopic guidance, using a Ciaglia-style dilator kit. Faster, smaller scar, fewer infections than open - where anatomy allows.

  • Surgical open

    In theatre, formal skin incision, strap muscles split, thyroid isthmus divided or retracted, tracheal window fashioned. Preferred for difficult necks, children, coagulopathy or emergency airway.

  • Cricothyroidotomy

    True emergency airway through the cricothyroid membrane. A rescue procedure, not an elective one - usually converted to formal tracheostomy within 24–72 hours.

  • Mini-tracheostomy

    A small 4 mm tube for secretion clearance only - not for ventilation. Useful when the cough is weak but the upper airway still works.

  • Paediatric tracheostomy

    Always open, always in theatre, always with stay sutures. Different tube sizes, different weaning pathway and formal parental training before discharge.

  • Cuffed vs uncuffed tubes

    Cuffed for ventilation and aspiration protection. Uncuffed or fenestrated for speech and later stages of weaning.

  • Fenestrated tubes

    A hole in the tube lets air pass up through the vocal cords - used with a speaking valve during weaning.

  • Permanent (end) tracheostomy

    After total laryngectomy the trachea is sewn to the skin as a permanent end stoma - different surgery, different aftercare, covered on our laryngectomy page.

Safety and recovery

What to expect afterwards - honestly.

Tracheostomy is common, but every stage from first tube change to decannulation deserves a proper plan and a bedside emergency algorithm.

  • Sedation or GA, always with a difficult-airway plan

    Percutaneous is sedation plus local; open is GA. In either case a bronchoscope, difficult-airway trolley and an anaesthetist are on standby.

  • Bleeding - early and late

    Early bleeding from thyroid vessels or strap muscles is common but usually minor. Late tracheo-innominate fistula (weeks in) is rare but catastrophic - pulsatile bleeding needs 999.

  • Pneumothorax and surgical emphysema

    Small pneumothoraces occur in a few percent. A routine chest X-ray after the procedure catches them. Surgical emphysema settles as the wound seals.

  • Tube displacement in the first week

    The stoma tract is not yet mature. If the tube falls out or comes back through a false passage, call the airway team - do not push a fresh tube blindly.

  • Blocked tube

    Thick or dry secretions can block a tube in minutes. Humidified oxygen, regular suction and a spare inner cannula at the bedside are non-negotiable.

  • Infection and granulation tissue

    Stomal infection is common but usually mild. Granulation tissue at the stoma or in the trachea can bleed or narrow the airway - treatable with silver nitrate or laser.

  • Voice, swallowing and psychological impact

    A cuff inflated for ventilation blocks voice. Speech returns with cuff deflation and a speaking valve. Swallow is often affected - SLT input matters.

  • Tracheal stenosis, months later

    Around 1–2 percent develop narrowing at the cuff or stoma site, months after decannulation. Persistent stridor or exercise breathlessness deserves a look with ENT.

  • Red flags after discharge

    A blocked tube not cleared by suction, tube displacement, heavy bleeding, spreading redness or new fever needs the same-day team, not a routine call.

Reading your operation note

Your tracheostomy note in four parts. Read the last one first.

Whichever technique was used - percutaneous or open - the note the team writes keeps to the same shape.

A UK consultant reviewing a patient’s tracheostomy notes

A quiet reminder

Airway language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the operation note and the weaning plan before your review, just ask.

  1. 01 Header

    Indication, approach and tube

    Why the tracheostomy was done, whether percutaneous or open, and the exact tube type, size and cuff status placed.

  2. 02 Technique

    Anatomy and findings

    Neck anatomy, level between which tracheal rings, thyroid isthmus handled, any bleeding controlled and bronchoscopic view at the end.

  3. 03 Findings

    First tube change and weaning steps

    When the first tube change is planned, when cuff deflation starts, speaking valve, downsizing schedule and decannulation criteria.

  4. 04 Impression

    Emergency plan and follow-up

    Read this first: what to do if the tube blocks or displaces, community nursing plan, and the ENT follow-up for decannulation and stoma review.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Tracheostomy is usually covered when medically indicated as part of an ICU or head and neck surgery episode.

Frequently asked

Everything we get asked about tracheostomy.

Quick answers on percutaneous vs open, speech, swallow, cost and coming off the tube.

  • Is a tracheostomy permanent?

    Almost always no. The great majority of tracheostomies placed for ventilation, secretion control or airway swelling are temporary - the tube comes out (decannulation) once the underlying problem is fixed and the stoma usually closes on its own within a week. Permanent stomas are reserved for total laryngectomy or fixed upper airway obstruction that cannot be bypassed any other way.

  • Percutaneous or open - which is better?

    For a stable adult in ICU with normal neck anatomy, percutaneous at the bedside is faster, has a smaller scar and lower wound infection rates. Open surgical is preferred for children, difficult necks (short, obese, previously irradiated), bleeding disorders, and true emergencies where the airway is losing ground.

  • Will I be able to speak?

    Not while the cuff is up and you are ventilated - air bypasses the vocal cords. As weaning progresses the cuff comes down and a speaking valve lets air pass through the larynx again, so voice returns. After decannulation the voice is usually normal or near-normal.

  • Can I eat with a tracheostomy?

    Often, yes - but swallow safety needs a speech and language therapy assessment first. Cuff deflation is usually needed. Some patients need thickened fluids or texture-modified food for a period, and a few need alternative feeding until the swallow recovers.

  • How long does a private tracheostomy cost in the UK?

    Roughly £3,500–£6,500 for a percutaneous bedside procedure, £5,500–£9,500 for a surgical open tracheostomy, and £8,000–£14,000 for a paediatric case - before ICU stay, tubes and follow-up.

  • What happens after decannulation?

    The tube comes out, the stoma is dressed and it usually granulates closed within a few days to a week. A small scar remains. Voice, cough and swallow are all reviewed. If the stoma leaks air for more than two weeks a small procedure to close it can be done.

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