Physiological

There are some similarities between the changes that occur following tracheostomy and those that occur following laryngectomy. A tracheostomy involves the anatomical potential for air to still flow via the upper airways (nose and mouth) although this may not be the case.

Question: Can you think why?

Answer

There are some similarities between the changes that occur following tracheostomy and those that occur following laryngectomy. A tracheostomy involves the anatomical potential for air to still flow via the upper airways (nose and mouth) although this may not be the case.

Question: Can you think why?

Answer: If the upper airway is obstructed or if there is a cuff-inflated tracheostomy tube in situ then gas will only flow via the neck, just like a laryngectomy. Remember that a laryngectomy is a permanent procedure.

Can you think why these other changes listed below occur? Click on the headings to explore other physiological changes.

There are some similarities between the changes that occur following tracheostomy and those that occur following laryngectomy. A tracheostomy involves the anatomical potential for air to still flow via the upper airways (nose and mouth) although this may not be the case.

Question: Can you think why?

Answer: If the upper airway is obstructed or if there is a cuff-inflated tracheostomy tube in situ then gas will only flow via the neck, just like a laryngectomy. Remember that a laryngectomy is a permanent procedure.

Can you think why these other changes listed below occur? Click on the headings to explore other physiological changes.

Coughing

Try coughing now. You breathe in, pause, then start to exhale against a closed glottis – your larynx closes your vocal cords. This causes a build-up of pressure inside your trachea. Then, your vocal cords open quickly, and you forcibly exhale.

Try doing it again without closing your throat. You will need to make a 'hah' sound rather than a 'k-hah'. You will find that without the larynx, a cough is less explosive, and less effective.

Laryngectomees can find ways to make their coughing stronger but they are more prone to chest infections and find it more difficult to clear phlegm, partly due to the lack of a larynx.

Pulmonary function tests are also reduced following laryngectomy.

There are some similarities between the changes that occur following tracheostomy and those that occur following laryngectomy. A tracheostomy involves the anatomical potential for air to still flow via the upper airways (nose and mouth) although this may not be the case.

Question: Can you think why?

Answer: If the upper airway is obstructed or if there is a cuff-inflated tracheostomy tube in situ then gas will only flow via the neck, just like a laryngectomy. Remember that a laryngectomy is a permanent procedure.

Can you think why these other changes listed below occur? Click on the headings to explore other physiological changes.

Reduced nasal function

Because laryngectomees no longer breathe in (or out) via the nose, the normal protective mechanisms of the nose are lost. This includes warming and humidifying inspired air and trapping dust and particles in the hairs and mucus normally encountered in the nose. Some humidification must be provided. This is especially important if the patient becomes dehydrated, unwell, or is hospitalised.

Patients can learn a technique to draw air into the nose, to help with the sense of smell. It involves yawning with the mouth closed, drawing air into the nose and pharynx. This technique can help improve taste sensations too.

There are some similarities between the changes that occur following tracheostomy and those that occur following laryngectomy. A tracheostomy involves the anatomical potential for air to still flow via the upper airways (nose and mouth) although this may not be the case.

Question: Can you think why?

Answer: If the upper airway is obstructed or if there is a cuff-inflated tracheostomy tube in situ then gas will only flow via the neck, just like a laryngectomy. Remember that a laryngectomy is a permanent procedure.

Can you think why these other changes listed below occur? Click on the headings to explore other physiological changes.

Swallowing

Your larynx is intimately involved in the action of swallowing. Put your hand on the front of your neck and swallow now.

Swallowing is difficult immediately after surgery, but problems can persist due to the altered anatomy and physiology after the larynx has been removed.

Appetite can also be affected by altered smell sensation as taste depends partly on smell. Patients may be advised to add more flavouring to your food, such as spices and herbs.

There are some similarities between the changes that occur following tracheostomy and those that occur following laryngectomy. A tracheostomy involves the anatomical potential for air to still flow via the upper airways (nose and mouth) although this may not be the case.

Question: Can you think why?

Answer: If the upper airway is obstructed or if there is a cuff-inflated tracheostomy tube in situ then gas will only flow via the neck, just like a laryngectomy. Remember that a laryngectomy is a permanent procedure.

Can you think why these other changes listed below occur? Click on the headings to explore other physiological changes.

Valsalva manoeuvres

Lifting heavy things and opening the bowels involves holding gas in the chest against a closed glottis - you breathe in and hold your breath. This action can help to stabilise the spine and abdomen to help with lifting and can help with going to the toilet. Following a laryngectomy, it is difficult to hold your breath, and almost impossible to generate any significant intrathoracic pressure.

Constipation should be discussed and actively avoided.