A tracheal trough procedure is a surgical technique used to create a larger or more stable airway opening in the trachea. It may be performed as part of complex airway reconstruction, often when there has been long-standing tracheostomy use, subglottic stenosis, or tracheomalacia (weak or collapsing trachea). The goal is to improve breathing without the need for ongoing airway tubes.

In this procedure, the surgeon reshapes or removes part of the front of the trachea and may use grafts or stents to maintain the new, wider contour. It is done under general anesthesia, and recovery depends on the extent of the reconstruction. Some patients may need a temporary stent or tracheostomy during healing. Postoperative care includes frequent endoscopic evaluations, airway humidification, and voice rest if vocal structures are involved. This procedure is highly individualized and planned according to airway imaging and scope findings.