Tracheotomy allows you to continue breathing after laryngectomy
The larynx plays an important role in controlling breathing. When the entire larynx is removed, surgeons need to create a new way of breathing. Your surgical team will create a hole in your neck, a procedure known as a tracheotomy. Your surgeon will permanently connect your windpipe or trachea, which carries air to the lungs, to this hole in your neck. Breathing, coughing, and sneezing now occur through this hole, called a tracheostomy or a “stoma,” rather than through your nose and mouth.
Tracheotomy recovery and learning to use a trach tube and stoma button
The stoma may be held open with a tube you breathe through. This tube is called a tracheostomy tube, or trach tube. The trach tube stays in place for a few weeks, until the skin around the stoma heals. Some people continue to use the tube all or part of the time. If it is removed, a smaller tracheostomy button called a stoma button, often replaces the tube. After a while, some people don’t use a tube or a button in the stoma.
After surgery, your lungs and windpipe make a lot of mucus, also called sputum. To remove the sputum, a nurse applies suction with a small plastic tube placed in the stoma. Soon, you learn to cough and suction mucus through the stoma without the nurse’s help. It may also be necessary to suction saliva from your mouth if swelling in your throat makes it hard to swallow.
Normally, the tissues of your nose and throat moisten air before it reaches your windpipe. After surgery, air enters your trachea directly through the stoma and cannot be moistened in the same way. While in the hospital, you are kept comfortable with a special device that goes over the stoma and adds moisture to the air. After your discharge from the hospital, you may use a piece of light fabric to cover the stoma to protect your airway from dust and particles in the air. You must take care to keep the stoma from drying out and to keep foreign substances or water from getting into it. With a stoma, you cannot hold your breath so activities that require straining or holding your breath may be difficult.
After a partial laryngectomy, a short-term tracheostomy may be needed. Then the trach tube is removed from the stoma. Over the next few weeks, the stoma closes. You then breathe and speak in the usual way, although your voice may not sound the same as before.
The stoma must be properly cared for to prevent problems and complications. Your health care team will help you learn how to care for it.