LARYNGECTOMY FAQ'S

Should I irrigate the stoma and humidify my air supply?
(by Glenn E. Peters M.D., Director, Division of Otolaryngology
Head and Neck Surgery, University of Alabama at Birmingham,
Birmingham, Alabama, USA)

Let's talk about your ‘air conditioning’ system. Before your laryngectomy you were breathing through your mouth and more importantly through your nose. Your inspired air was being filtered and humidified by your upper respiratory tract. Inspired air was taken from the relative humidity of your ambient air and moisturized up to 100% by the time it reached the gas exchange units in your lungs, called alveoli. At the same time, particulate matter was removed by the mucous blanket, which coats the lining of the nose and throat.

After your laryngectomy, you are left without this normal filtration/humidifying system. Your lungs respond in a very normal and protective manner by producing an increased amount of mucous to filter and humidify the air that is coming in. Bloody sputum can result when you cough excessively to clear this increased amount of mucous. You also may be more susceptible to bronchitis (an infection and inflammation of the lining tissues of the tracheo-bronchial tree) because you are breathing unfiltered, dehumidified air.

So, what to do? Everything possible to increase the amount of moisture in the air you inhale. Irrigate your stoma with clean tap water or saline solution four times a day and it will help your breathing. You will be taught how to do this in the hospital, but it is very simple. Fill a syringe with two to three cc's of water, take a deep breath and squirt some of the water into your stoma. You will cough and you are supposed to. If you cough before you get much water into the stoma, repeat immediately. You are softening any bits of hardened mucous or blood and coughing it out. This is extremely important.

A cool mist humidifier in your bedroom will help you to breathe moist air while sleeping. Put fresh water in daily, and every week or two, to prevent bacteria, clean and soak the tank with a solution of one teaspoon of bleach in one gallon of water. Rinse thoroughly before refilling.

Some tricks for retaining warmth and humidity in your trachea and lungs include wearing a stoma bib, but you can also wear a scarf, a turtle neck shirt or sweater. Foam stoma protectors are also available. Covering your stoma allows you to conserve the moisture that is trying to leave your lungs as you exhale. You might also wear a soft stoma vent (see your MD for the proper size). A small plastic spray bottle filled with clean tap water can be used to create a mist to dampen your stoma bib. It becomes a portable humidifier. Lastly, be patient. Your lungs are going through some major changes. Ultimately, they will adapt to the new you. Things generally improve within 3 to 4 months after surgery.