Tracheotomy And Laryngectomy Flashcards
What is the difference between tracheotomy and tracheostomy
Tracheotomy- surgical creation of a hole into the neck
Tracheostomy- the tube that enters the opening in the neck
What is a laryngectomy
Total removal of the larynx and hyoid bone
The upper trachea is brought into the anterior of the neck to create a permanent hole for breathing
Why would a tracheotomy be used?
If there is an inability to breath properly
- head injury
a blockage
remove fluid if there is an infection or someone is unable to cough
PERMANENT or TEMPORARY
Why laryngectomy
Usually cancer
Sometimes non functional larynx after chemo
Rarely to prevent aspiration in neurological dysphagia
What are the different forms of the tracheostomy tube
Cuffed/ Un cuffed
Fenestrated/ un fenestrated
Discuss communication in a tracheostomy
Can articulate normally and mouth
AAC/ writing
If the tube is incurred and fenestrated laryngeal phonation can occur (cover hole with finger so air goes through larynx)
Passy ( a valve meaning a finger is not required)
Discuss tracheostomy and swallowing
Aspiration can still occur
Aspiration is multifactorial not just linked to tracheostomy
The tracheostomy causes physiological changes eg desensitisation of the larynx so cough is less effective
What is the massive long word?
Pharyngolaryngoesphagectomy
What occurs in a Pharyngolaryngoesphagectomy
Laryngopharynx, larynx and oesophagus removed and stomach is pulled up
Describe the different forms of laryngeal voice
Voice prosthesis- a tracheal to oesophagus trache used
Electronic larynx- vibrating device
Oesophageal voice- similar to burping, air forced down and then back up
Silent articulation
How does laryngeal voice work without a larynx
Pharyngoesophageal segment vibrates instead
Why does laryngeal voice not work if you have had a Pharyngolaryngoesphagectomy
Because there is no pharyngoesophageal segment so voice quality is wet
