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Patients with laryngeal carcinoma, a malignant disease from the group of head and neck tumors, receive a tracheostoma either temporarily or permanently (definitive). The tracheostoma is a surgically created opening of the windpipe (trachea) through the soft parts of the neck, above or below the thyroid gland, through which the patient then breathes. The final tracheostoma is always located below the thyroid gland and is also larger.

After the surgical procedure, it is important that affected persons get used to the system as soon as possible and learn independence and professional actions. However, expert caregivers must be careful about wound care of the fresh wound on the neck. Blood and secretions can also clog the freshly placed tracheal cannula, so close monitoring is a very important initiative. Infection of the lungs should also be ruled out, so the bronchial secretions should be regularly aspirated through the tracheostoma to prevent pathogens and germs from taking hold. Inhalers and ultrasonic nebulizers are also recommended to dilute the respiratory secretion and keep it fluid.

A plastic filter, the so-called heat and moisture exchanger (HME), is placed on the inner cannula of the tracheostoma. It fulfills important functions. First, it warms the outside air to body temperature, humidifies the breathing air, and provides a relatively normal breathing resistance that has been lost due to the surgery. Coughing and mucus secretions are also prevented by the device.

Intercostal muscles

If the HME were absent, there would be an absence of respiratory resistance. The affected person adopts a protective breathing pattern that omits nasal breathing. As a result, the so-called intercostal muscles are no longer used properly. The respiratory volume decreases and so does the oxygen supply. Shortness of breath and fatigue are the result. In addition, the filtering of the breathing air by the hairs and mucous membrane in the nose is no longer possible. Humidification of the air breathed in the nose is also absent, with the overall result that mucus can no longer be properly removed to the outside. Also, a „Stom-Vent“ as heat and fluid exchanger is placed on the tracheostoma to catch the exhaled moisture, but also to stimulate warming of the outside air and humidification.

The care of the tracheostoma is not very complex if the patient has experienced it. It should be known that protective caps should be worn before showering or bathing so that no water can run into the cannula. A wet shave is also recommended for men to prevent dry stubble from entering the system. In addition, cotton swabs should not be used to clean the entry site.

Source: www.curado.de