This is a question that is often asked by patients’ families. It is usually asked, the doctor said he is going to cut it open, do we cut it or not? Or they ask, “The doctor asked us to sign that the larynx should be cut, so is it the end of the patient? Or they may say, “You are trying your best to save the patient, but we will not treat him if he is cut. And so on. It is still necessary to explain my understanding of tracheotomy. An artificial airway is necessary if a patient needs to be continuously ventilated for various reasons, such as respiratory failure, cerebral hemorrhage, after cardiac arrest, cardiac failure, and so on. The most common type of artificial airway is a tracheal tube placed through the mouth. The operation itself is not damaging and almost all patients undergoing general anesthesia are placed with a transoral tracheal tube, which can be removed after surgery. However, if the patient cannot be removed from the ventilator and the transoral tracheal tube is left in place for a long period of time, there are the following problems: 1. Pain. Having a foreign body continuously placed into the trachea through the voice box is similar to the sensation of choking on a drink of water, which is usually not easily tolerated and requires continuous sedation, making it difficult to keep the patient awake. 2.There is a tracheal intubation in the mouth, and it is impossible to eat. 3.The tracheal intubation in the mouth is compressed, and ulceration and infection of the tongue and lips occur. 4.It is not easy to perform cleaning, and bacteria can easily accumulate in the mouth, leading to infection. 5.The vocal cords cannot be closed, and bacteria in the mouth, etc. can easily enter the airway, leading to infection. And so on. Therefore, the medical routine is to choose 2 weeks as a time point. If the patient is still not able to get off the ventilator after 2 weeks of tracheal intubation, tracheotomy is recommended, and if it is done, the above mentioned deficiencies of transoral tracheal intubation can be corrected. The procedure can be done at the bedside with minimal trauma. Therefore, tracheotomy is only a change of access to the ventilator, and the tracheotomy tube can be removed for later recovery without surgery, and the wound can grow back on its own. Of course, tracheotomy also has the corresponding complications, at present does not support early incision, treatment for about 2 weeks before considering is appropriate, but is not absolute, if you feel that the patient 3 weeks can definitely pull out the tube, and then wait is also possible. Transnasal tracheal intubation is no longer an option for long-term tracheal access due to the possibility of local infection.