A laryngectomy tube is a medical device used to maintain an open airway after surgery. It keeps a surgically created opening in the neck, known as a stoma, from closing.
What is a Laryngectomy Tube?
A laryngectomy tube is a flexible silicone tube designed to maintain the stoma following a total laryngectomy surgery. This tube is placed into the opening in the neck, connecting directly to the windpipe and ensuring a continuous pathway for air to reach the lungs. Laryngectomy tubes are small, soft, and shaped to mimic the natural curve of the trachea. They come in various sizes to accommodate individual patient needs.
The primary function of a laryngectomy tube is to prevent the stoma from shrinking or closing, maintaining a patent airway. Unlike some other breathing tubes, laryngectomy tubes are not attached to a ventilator. While both procedures create an opening in the neck for breathing, a laryngectomy tube is distinct from a tracheostomy tube. A tracheostomy tube is used after a tracheotomy, where the connection between the nose, mouth, and airway remains intact, primarily helping with breathing or ventilation. In contrast, a laryngectomy permanently disconnects the windpipe from the nose, mouth, and throat, meaning breathing occurs solely through the stoma.
Why Are Laryngectomy Tubes Used?
Laryngectomy tubes are used following a total laryngectomy, the complete removal of the larynx or voice box. This surgery is performed when the larynx is severely damaged or affected by advanced conditions. The most common reason for a total laryngectomy is advanced laryngeal cancer.
Other medical conditions necessitating this procedure include severe laryngeal trauma or chondronecrosis of the larynx. After the larynx is removed, a permanent stoma is created, and the laryngectomy tube is placed to ensure this new breathing pathway remains open.
Living with a Laryngectomy Tube
Life with a laryngectomy tube involves adjustments to daily routines, particularly concerning breathing, communication, and physical activities. Since air no longer passes through the nose and mouth, it loses the natural warming and humidifying process. This leads to increased mucus production and a need for external humidification, such as using a heat and moisture exchanger (HME) device that attaches to the tube.
Communication changes significantly, as the vocal cords are removed during a total laryngectomy. Individuals learn alternative methods of speech, such as esophageal speech, or utilize devices like a voice prosthesis (tracheoesophageal puncture or TEP) or an electrolarynx. Eating and swallowing become normal after recovery, though a feeding tube may be used initially while healing. Activities like showering require careful protection of the stoma with a shower guard, and swimming or water sports are not advised due to the risk of water entering the airway.
Caring for a Laryngectomy Tube
Proper care of a laryngectomy tube is important to prevent complications and maintain a clear airway. The tube requires cleaning at least once a day, or more frequently if there is thick or sticky mucus. Cleaning involves removing the tube and scrubbing it with a small brush, using mild soap and warm water, then rinsing thoroughly. Certain chemicals like hydrogen peroxide or rubbing alcohol should not be used for cleaning the tube.
The skin around the stoma also needs daily cleaning with damp gauze to remove secretions and prevent irritation. Caregivers should look for signs that may indicate a need for medical attention, such as excessive crusting, difficulty breathing, whistling or gurgling sounds from the stoma, or mucus bubbling up from the tube. Hand hygiene is important before and after any tube care to prevent infection.