 Tracheotomy consists of making an incision on the front of the neck and opening a direct airway through an incision in the trachea . The resulting opening can serve independently as an airway or as a site for a tracheostomy tube to be inserted ; this tube allows a person to breathe without the use of his nose or mouth . The opening may be made by a scalpel or a needle ( referred to as surgical and percutaneous techniques respectively ) and both techniques are widely used in current practice . In order to limit the risk of damage to the recurrent laryngeal nerves ( the nerves that control the voicebox ) , the tracheotomy is performed as high in the trachea as possible . If only one of these nerves is damaged , the patient 's voice may be impaired ( dysphonia ) ; if both of the nerves are damaged , the patient will be unable to speak ( aphonia ) . In the acute setting , indications for tracheotomy are similar to those for cricothyrotomy . In the chronic setting , indications for tracheotomy include the need for long @-@ term mechanical ventilation and removal of tracheal secretions ( e.g. , comatose patients , or extensive surgery involving the head and neck ) . 
