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Clinical Care and Rehabilitation in Head and Neck Cancer pp 119–128Cite as

Clinical Intervention for Airway Improvement: Establishing a New Nose

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Abstract

Total laryngectomy results in a permanent, anatomical disconnection between the upper and lower airways, a process which directly impacts breathing in addition to other functional activities (e.g., smelling, tasting). Specifically, this includes changes in airway humidification, filtration, warming, and resistance as laryngectomees no longer have air actively passing through the nose and mouth, subsequently resulting in unconditioned airflow into the trachea and lungs. This chapter details the basic properties and benefits of heat and moisture exchange devices and explores available treatment options for airway protection and improvement following total laryngectomy. Of primary importance in this chapter is the goal of providing clinicians with a framework for assessing and managing pulmonary environments for laryngectomees as they work to establish a “new nose” for those who undergo total laryngectomy.

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Acknowledgments

I would like to acknowledge Marlene Lesnoff, the first laryngectomee I ever met and my mother-in-law. She taught me long before I entered this profession that life does not end post-laryngectomy, but it does change in ways that many do not appreciate. Her larynx was removed but not her joy, which was evident when she used her electrolarynx to tell inquisitive children she was Darth Vader’s mother. Passing before I became a speech pathologist, it is her memory and passion that goes with me as I’ve had the privilege of helping these patients.

I am also deeply grateful for the incredible gift Marlene gave me in her daughter, who, along with my children, tolerated late nights of me with my nose buried in texts. I am forever grateful for their support, patience, and love.

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Authors and Affiliations

  1. Department of Surgery, Walter Reed National Military Medical Center, Bethesda, MD, USA

    W. J. Bryan Lewis

  2. Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    W. J. Bryan Lewis

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Editors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery and School of Communication Sciences & Disorders , Western University, London, ON, Canada

    Philip C. Doyle

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Bryan Lewis, W.J. (2019). Clinical Intervention for Airway Improvement: Establishing a New Nose. In: Doyle, P. (eds) Clinical Care and Rehabilitation in Head and Neck Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-04702-3_8

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  • DOI: https://doi.org/10.1007/978-3-030-04702-3_8

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