Pediatric treacheostomyIn most of the cases tracheostomy is performed with general anesthesia and the patient intubated and paralyzed. Neck is extended. A horizontal incision is made halfway between the cricoid cartilage and the sternal notch. Subcutaneous fat and tissues are reflected, and deep cervical facia, is cut to expose thyroid isthmus. A vertical cut is given in 2-3 or 3-4 rings in midline and no part of the tracheal wall is removed. The endotracheal tube is withdrawn and a suitable size tracheostomy tube is simultaneously inserted. Post-operatively neck & chest radiograph are obtained to evaluate the position of the tube and to identify the subcutaneous emphysema & pneumothorax that could have developed as complication. Tube must be cleaned at frequent intervals. Patient should be nursed in and atmosphere of moist air.