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 This is performed to create a permanent tracheal fistula, or stoma. A tracheal stoma can be created when the obstruction to airflow is severe and permanent.

 Creating a tracheal stoma involves removing a portion of four or five adjacent tracheal rings and suturing the tracheal mucosa and submucosa to the surrounding cutaneous incision.

 The term permanent tracheostomy is sometimes used to describe a stoma that is maintained only during a working season for the horse. This is similar to a temporary tracheostomy but is performed because the obstruction to airflow interferes only with the work of the horse. Though termed a “permanent” tracheostomy, this tracheostomy is not actually permanent, because the tracheostomy tube is removed after the working season of the horse, when it is no longer required. The tube is replaced, in preparation for the horse's next working season, after performing another tracheostomy.

Figure 4.11 Permanent tracheostomy performed to bypass laryngeal obstruction causing severe dyspnea.

Source: Courtesy of: Dr. Peter Rakestraw, VMD, Dip ACVS.