Postlaryngectomy Stoma versus Tracheostomy ... | 合法醫療器材資訊網

由ATTruong著作·2019·被引用3次—Atracheostomyisasurgicalopeningtoaccessthetracheallumenwiththeentirelarynxremainingintact(D).Incontrast,aftertotallaryngectomy,thetracheais ...

Patients with a postlaryngectomy stoma present important and often unrecognized implications for perioperative airway management. Because of its appearance and location, the stoma (A) is often mistaken for a tracheostomy (B). A tracheostomy is a surgical opening to access the tracheal lumen with the entire larynx remaining intact (D). In contrast, after total laryngectomy, the trachea is brought to the skin as a stoma, which no longer has any anatomical connection with the oropharyngeal cavity and digestive tract (C). Consequently, it is impossible to deliver oxygen to the lungs with nasal cannula, face mask, or bag-mask ventilation. Attempts to intubate the trachea from above the stoma via the oral or nasal route will be unsuccessful. Similarly, because pulmonary aspiration of gastric contents cannot occur, these patients do not need to be kept nil per os for surgery.1  Conversely, the risk of foreign body...