Pulmonary function after total laryngectomy

Objective: To present data on pulmonary function in 59 laryngectomees using a specially designed silicone adapter for connection of the stoma to the b odyplethysmograph. Study Design: Prospective assessment of pulmonary functi on in 59 patients, and comparison of lung function before and after broncho dilator testing in selected cases. Methods: The usefulness of the adapter w as examined. Data of patients with airway obstruction were tabulated accord ing to large airway obstruction (LAO), peripheral airway obstruction (PAO), and small airway disease (SAD) types. Results: Findings show that pulmonar y airway obstruction was present in 81% of patients and normal pulmonary fu nction was present in only 11 of the 59 participants (19%). LAO was found i n 25%, PAO in 17%, and SAD in 39% of cases. Emphysema was diagnosed in 14% of cases within the above-mentioned LAO and PAO groups. Improvement of pulm onary function was achieved in 12 of 16 laryngectomees with airway obstruct ion, when a bronchodilator aerosol was administered. In 60% of cases with L AO and PAO, the laryngectomees did not know of any marked obstruction of th eir airways, and only 10% of those knowing about their obstruction received appropriate medical treatment. Conclusions: These results suggest that 42% of the laryngectomees tested may have benefited from further medical treat ment. After laryngectomy, pulmonary function assessment was performed elsew here in 1 of 59 cases. In light of the high prevalence of airway obstructio n in laryngectomees, more frequent postoperative assessments of pulmonary f unction should be offered to prevent or to reduce impairment of respiratory function in this postlaryngectomy vulnerable pulmonary status. Further stu dies are also needed to determine the effects of therapeutic intervention, e.g., assessment of therapy outcome and influence on quality of life.