An opening in someone’s neck, particularly in individuals who smoke, often points to serious underlying health conditions. This alteration results from medical interventions to restore breathing or manage severe disease. Such an opening indicates a significant impact on the respiratory system, linked to the long-term effects of tobacco use. Understanding these procedures and their causes can shed light on the severe consequences of smoking.
Identifying the Openings: Tracheostomy and Laryngectomy
Two distinct surgical procedures can result in an opening in the neck for breathing: a tracheostomy and a laryngectomy. Both create a stoma in the front of the neck, but their purposes and implications differ. A tracheostomy involves surgically creating an opening directly into the trachea, or windpipe, to allow air to enter the lungs. This procedure includes inserting a tube to keep the stoma open, facilitating breathing when the upper airway is obstructed or when long-term mechanical ventilation is needed.
Unlike a tracheostomy, which can be temporary and maintains the connection between the nose, mouth, and lungs, a laryngectomy involves the complete surgical removal of the larynx, also known as the voice box. After a laryngectomy, the remaining trachea is reconnected directly to the stoma in the neck, permanently disconnecting the nose, mouth, and throat from the windpipe. Breathing then occurs solely through the stoma, and individuals require alternative methods for speech.
The Primary Culprit: Laryngeal Cancer
Laryngeal cancer is a primary reason why smokers may undergo procedures like a tracheostomy or laryngectomy. This cancer originates in the larynx, often called the voice box, located at the top of the windpipe. The larynx houses the vocal cords, responsible for speech, and functions as a valve, opening for breathing and closing to prevent food and liquids from entering the trachea during swallowing.
Laryngeal cancer develops when cells within the larynx mutate and multiply uncontrollably, forming a tumor. The cancer can occur in any of the larynx’s three main parts: the glottis (where the vocal cords are located), the supraglottis (above the vocal cords), or the subglottis (below the vocal cords). As the tumor grows, it can obstruct the airway, making breathing difficult, or damage the vocal cords, leading to voice changes such as hoarseness. In advanced stages, the tumor may invade surrounding tissues, including the trachea, necessitating the removal of part or all of the larynx.
How Smoking Causes Damage
Smoking is a major factor in the development of laryngeal cancer due to the direct exposure of the larynx and airways to thousands of harmful chemicals in cigarette smoke. Over 7,000 chemicals are present in tobacco smoke, with at least 70 identified as carcinogens, or cancer-causing substances. These include polycyclic aromatic hydrocarbons (PAHs), formaldehyde, benzene, and tobacco-specific nitrosamines.
Upon inhalation, these toxic chemicals come into direct contact with the cells lining the larynx and airways. This chronic irritation and exposure can lead to cellular changes and DNA damage within these cells. DNA damage can result in mutations in genes, which trigger uncontrolled cell growth and division. Additionally, some components in cigarette smoke, such as nicotine, can weaken the body’s immune system and suppress programmed cell death, allowing damaged cells to survive and multiply.