The development of advanced neonatal care and anesthesia techniques enabled patients to be intubated for prolonged periods leading to a rise in incidence of acquired subglottic stenosis and the survival of patients with ventilator-dependent respiratory failure. The decision for tracheotomy tube placement should entail a detailed thought process and individualized plan for each patient. When evaluating children for tracheotomy tube placement, it is important to communicate openly with anesthesia staff. Correct size and positioning of the tracheotomy tube can be confirmed with a post-operative chest radiograph and/or passage of a small pediatric flexible endoscope. After tracheotomy, the patient should be closely monitored in the intensive care unit for 5-7 days. Careful dissection and ligature techniques are used for anterior jugular veins and the thyroid isthmus to avoid complications. Patients with tracheotomies have been shown to exhibit difficulties with speech and language development, even after decannulation.

The development of modern anesthesia techniques involving the ventilation of the patient's lungs and the use of tracheal tubes in intensive care and anesthesia was a great impetus to the development of surgery in general. The types of procedures carried out on the trachea that require general anesthesia are rigid bronchoscopy, tracheal stenting and excision of tracheal stenosis or tumors. Rigid bronchoscopy can be used for diagnostic purposes by examining and assessing the tracheobronchial tree anatomy and by the taking of a biopsy for histology. Silicone rubber stents require general anesthesia for placement while metallic expandable stents can be placed fluoroscopically or under general anesthesia. The indications for tracheal resection are symptomatic stenosis or benign and malignant tumors. Tracheal stenosis is most often caused by trauma such as prolonged intubation of the trachea in the intensive care unit.