Respiratory Infection Prevention for Laryngectomees

By: Itzhak Brook, M.D. MSc., HNCA Board Member, HNCA Ambassador, Throat Cancer Survivor and Laryngectomee

Laryngectomees are more susceptible to respiratory infection because the air they inhale is not filtered by passing through the nose. Consequently, they are at increased risk of inhaling respiratory pathogens (viruses, bacteria, and fungi) directly into their lungs. Therefore, laryngectomees have to be vigilant and protect themselves from all respiratory pathogens during the influenza season and other viral epidemics.

Respiratory pathogens are most commonly spread from an infected person to others through:

  • The air by coughing and sneezing and rarely, fecal contamination
  • Close personal contact, such as touching or shaking hands
  • Touching an object or surface with the pathogen on it, then touching the stoma, mouth, nose, or eyes before washing hands.

Laryngectomees can protect themselves by getting vaccinated (when a vaccine is available) and:

  • Wearing HME 24/7 especially when being around other people. HME with greater filtering ability would work better in reducing the risk of inhaling the virus ( i.e., Provox Micron TM, Atos Medical’s XtraMoist).
  • Wearing a facemask (preferably N95) over the stoma
  • Washing hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available. This especially important before managing their stoma, and touching their HME when speaking using tracheoesophageal speech.
  • Avoid touching the stoma, HME, eyes, nose, and mouth with unwashed hands.
  • Avoiding close contact with sick people.
  • Cleaning and disinfect frequently touched objects and surfaces.

A surgical mask with four strings can be modified to fit over the stoma. One of the strings can be extended with an extra string, and the lower pair of strings can be tied behind the back.

If worn properly, a facemask can help block large-particle droplets, splashes, sprays or splatter that may contain germs (viruses and bacteria). Facemasks may also help reduce exposure of the wearer’s respiratory secretions to others.

While a facemask may be effective in blocking splashes and large-particle droplets, it does not filter or block very small particles in the air that may be transmitted by coughs, and sneezes. Facemasks also do not provide complete protection from germs and other contaminants because of the loose fit between the surface of the facemask and the skin over the stoma.

Some facemasks (i.e., N95) offer greater filtering abilities of germs and small dust particles. However, neck breathers and people with chronic respiratory, cardiac, or other medical conditions that make breathing difficult should check with their healthcare provider before using an N95 facemask because it can make it more difficult for the wearer to breathe.


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Kristi believes dentists can be a resource for early detection by conducting a thorough mouth, jaw, and throat examination upon every visit. “While the dentists couldn’t have prevented cancer, they possibly could have been a great resource for early detection. This could have saved my husband from going through such grueling treatments.”Kristi Mason
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