“…Indication of tracheostomy: In current study, the upper airway obstruction was the main indication for the tracheostomy (60.7%); this is due to the high incidence of laryngeal tumor in which the patient presented in advanced stage, also the high incidence of blast injury during the period of study led to the upper airway obstruction to be a main cause. The 2nd common cause of tracheostomy was when it performed as a part of other procedure for protection of the airway or due to difficult intubation, it was found in 21.3%, while prolonged ventilation as a cause for the tracheostomy was found in 18%.this results agreed with other study like, (Adeyi A Adoga, et al, 2009) 2 reported that upper airway obstruction was the commonest cause of tracheostomy it found in 63% of his patients, (Kato et al, 1990) 3 reported that airway obstruction was the predominant cause of tracheostomy found in 42%, Hussam, Rasheed, 1999 4 also reported that upper airway obstruction was the commonest indication found in 72.5% followed by tracheostomy for protection of airway in 22.5% and lastly for prolonged ventilation in 5%. Garap, J P et al, 1999 5 Reported that "the mechanical airway obstruction is the commonest cause of tracheostomy, followed by prolonged ventilation and lastly for protection of airway".…”