A tracheostomy tube helps you breathe after tracheotomy surgery, which creates a stoma (an opening) in your neck. A laryngectomy tube keeps a stoma open during healing.

Tracheotomy and laryngectomy are both surgeries that create a stoma (a small opening) in the front of your neck to allow direct access to your windpipe.

Tracheotomy can be temporary and reversible. The connection between your nose, mouth, and airway remains intact. Doctors use a tracheostomy tube to keep your stoma open and safely ventilate your lungs.

In contrast, laryngectomy permanently alters the anatomy of your airway. While doctors commonly use a laryngectomy tube during healing, it may not be needed in the long term.

Tracheotomy vs. tracheostomy

Although the terms “tracheotomy” and “tracheostomy” look very similar and are often used interchangeably, they’re not exactly the same. A tracheotomy is a procedure to cut into your trachea. A tracheostomy is the opening that results from a tracheotomy.

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During a tracheotomy, a surgeon creates a stoma in the front of your neck. This opening leads directly into your trachea (windpipe), bypassing your nose, mouth, and throat.

The surgeon will then need to place a plastic tube into the stoma to keep it open and allow direct ventilation of your lungs. This tube is called a tracheostomy tube. Tracheostomy tubes are often externally connected to mechanical breathing machines called ventilators.

Tracheostomy tubes come in different varieties depending on your needs. Some have cuffs to prevent air leaks and protect your lungs, cannulas for easy cleaning, or fenestrations to help you speak.

Tracheotomy is a reversible procedure a doctor can perform in an emergency. But some tracheotomies are planned and long-term, like when a person expects a long-term need for a ventilator.

Reasons for a tracheotomy

You may need a tracheotomy in the following situations:

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tracheostomy tube facilitating airflow and laryngectomy tube keeping a stoma openShare on Pinterest
Medical Illustration by Bailey Mariner

In a laryngectomy, surgeons remove your larynx (voice box) and connect your trachea directly to an opening at the front of your neck. This opening is called a laryngectomy stoma.

Unlike a tracheotomy, a laryngectomy permanently disconnects your windpipe from your nose, mouth, and throat. After laryngectomy, you’ll be able to breathe through your stoma only.

Doctors can place a tracheostomy tube in a laryngectomy stoma, such as when a ventilator is required during surgery.

But once surgery is complete, they can place a small, flexible silicone tube directly in the stoma. This is called a laryngectomy tube, which keeps the stoma open and promotes healing.

Not all people with laryngectomy stomas will require a tube, especially once their stoma is well-healed.

Reasons for a laryngectomy

The following conditions may require you to undergo a laryngectomy:

  • head and neck cancer
  • severe trauma to the larynx
  • radiation necrosis of the larynx (a complication of cancer treatment)
  • rare circumstances such as cranial nerve palsy or recurrent laryngeal papillomatosis
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Hospital staff will teach you how to care for your laryngectomy stoma and tube. They may offer the following guidelines:

  • Clean the skin around your stoma with gauze, mild soap, and water at least twice daily.
  • You can remove your laryngectomy tube and clean it with a special brush and clean water.
  • Use a home humidifier and saline (sterile saltwater) spray or mist to prevent your stoma from drying or crusting.
  • Use suction as needed to remove airway mucus and secretions. You might also use a special filter over your laryngectomy tube to humidify air and protect yourself from airway irritants.
  • When showering, use a special shield to keep excess water out of your stoma.

What is the difference between a stoma and a tracheostomy tube?

“Stoma” means hole or opening. Both tracheotomy and laryngectomy result in a moist pink stoma on the front of your neck.

A tracheostomy tube is a plastic tube placed into your stoma to allow ventilation of your lungs. Similarly, a laryngectomy tube is a small, flexible silicone tube that may accompany a laryngectomy stoma.

Can you suction a laryngectomy tube?

Yes. Usually, you’ll first remove and clean your tube, then attempt to cough or suction your stoma.

But, if needed, you can use a suction machine and catheter with your laryngectomy tube in place.

How often do you replace a laryngectomy tube?

Laryngectomy tubes need regular cleaning, and experts recommend replacing them every 3 months. Replace your tube earlier if you notice signs of wear, such as cracks, or if directed by your doctor.

Do you need a feeding tube after a laryngectomy?

During the first week after surgery, your doctor may equip you with a temporary nasogastric feeding tube. As you recover, your medical team will help safely reintroduce eating and drinking by mouth.

If cancer treatment or other medical problems cause prolonged difficulty with hydration and nourishment, surgical placement of a gastrostomy feeding tube can help.

Both tracheotomy and laryngectomy create a stoma in the front of your neck, through which you can breathe or be ventilated.

But unlike after a tracheotomy, your nose, mouth, and throat are permanently disconnected from your windpipe after a laryngectomy. The only way air can flow in and out of your lungs is through the stoma.

Tracheostomy tubes come in many sizes and with different features. Tracheostomy tubes are designed for tracheotomy stomas. But doctors can also use them in a laryngectomy stoma, especially if mechanical ventilation is needed.

After laryngectomy, it’s more common to use a laryngectomy tube to support your healing stoma. Laryngectomy tubes are small, soft, and mimic the usual curve of the trachea after laryngectomy surgery. They’re not usually attached to a ventilator.

Not all people will need to use a tube long-term after their laryngectomy surgery.