Surgical indications for tracheotomy 1, persistent coma difficult to wake up in a short time ( coma time greater than 6 hours, estimated 24 hours can not wake up). 2.With posterior group cranial nerve palsy, skull base fracture bleeding more CSF leakage is obvious. 3, chronic respiratory disease, sputum is not easy to cough up or there is misaspiration. 4, combined with serious chest injury, especially multiple multiple fractures and paradoxical breathing. 5.Inability to maintain normal oxygen saturation due to poor airway.