Cicily has an underdeveloped lower jaw (micrognathia). This was seen in her ultrasounds before she was even born and the reason we had a specialized pediatric ENT (ear nose and throat Dr.) in the OR when she was born. He immediately intubated her at birth and a week later did an operation to assess her airway. He performed a larongoscopy/bronchoscopy to visualize her airway and even took pictures of it for us. Because her jaw is small and set back, and our tongues are connected to our lower jaws (ah the cool things I've learned!!) , her tongue sits right on top of her trachea, inhibiting air to move in or out of her mouth, down through her trachea and into her lungs. So in the same surgery the ENT performed a tracheostomy on Cicily. The trach is a "plastic breathing tube" that goes into her trachea (wind pipe) directly underneath her vocal chords and allows her to breath!
The small side to the right of the pic is the portion that goes down through the hole in her throat and into her trachea.
This is looking straight on at the trach. The center round "ring" is the part we put the catheter into to suction out her secretions multiple times a day (much more when she's sick). The "wings" stick out on her neck.
The trach attached to the foamy trach holder that goes around Cis' neck and holds the trach in place. How we love velcro!!!
Trach with the Passy-Muir valve on. This valve allows speaking as it opens to allow air into the trach, but then closes on exhalation and forces the air up over the vocal chords and out the nose/mouth. Cicily only tolerates this when she is totally healthy and not "junky", so consequently we don't her her voice when she cries, laughs, etc. (Interesting side note- we've found hiccups still cannot be heard even with a Passy because they are an inhalation sound -I told you we've learned cool things!)
Trach as it usually looks on Cis with the Humid-vent on. This is also called an "artificial nose" as it has paper rolled up inside the plastic that moistens and warms the air that is inhaled.
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