II. Indications
- Head and Neck Cancer
III. Definitions
- Laryngectomy
- Entire glottis is reconstructed
- Stoma is the ONLY airway
- Connection to the nose and mouth has been surgically removed
-
Tracheostomy (in contrast to Laryngectomy)
- See Tracheostomy
- In the absence of Laryngectomy
- Communication with the nose and mouth is typically still patent
- Tracheostomy stoma is typically smaller than Laryngectomy stoma
- Tracheostomy tubes have a face plate with size and diameter information
- Laryngectomy tubes do not typically have a face plate
IV. Management: Emergency Care of Laryngectomy patients
-
Supplemental Oxygen
- Apply oxygen to the stoma
- Laryngectomy patients can NOT be oxygenated via the nose or mouth (no anatomic communication)
- Contrast with Tracheostomy, where anatomic communication with the upper airway typically persists
-
Bag Valve Mask
- Use a pediatric Bag Valve Mask applied over the stoma
- May attach to a Laryngeal Mask Airway (LMA) applied over the stoma
- Direct the LMA with the narrow side pointed inferiorly toward the Sternum
-
Endotracheal Tube
- Insert a cuffed tube into the stoma and inflate the cuff (similar process for both Laryngectomy and Tracheostomy)
V. References
- Mason and Bontempo (2026) Tracheostomy or Laryngectomy, EM:Rap, accessed 7/1/2026