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Post Surgery Equipment A wide range of products that a laryngectomee needs are now available on prescription. These are available from your GP but in East Lancashire all laryngectomees are registered with “Countrywide Supplies” who usually deliver your prescription free of charge to you home 24hours following order. NB: Laryngectomees should not have to pay for prescriptions. Stoma Care
Following surgery a laryngectomee has a stoma (a permanent hole that leads from their neck directly to the lungs). It is important that this area is kept clean and open. A number of creams and wipes are available to help with cleaning. It will also be necessary to wear a small tube or stoma button for a short time after the operation to protect the stoma and prevent it from shrinking down too quickly. Humidification Before the operation, air passed via the nose and mouth and was moistened and filtered prior to reaching the lungs. After a laryngectomy the nose and mouth are no longer used in this way and air leads directly from the stoma into the lungs. Consequently inhaled air needs to be filtered, warmed and moistened prior to entering the stoma. This is commonly known as a HME (a heat and moisture exchange system). A number of different products can be used to carry out this process and the laryngectomee can best decide the system that suits him/her. 1. Laryngofoam
These are small, disposable foam filters that are lightweight, comfortable and unobtrusive. They come in two sizes (51mm x 65mm and 65mm x 65mm) and two colours (white and beige). They are held securely in place by a hypoallergenic adhesive strip which covers the stoma and warms, moistens and filters incoming air. 2. Bibs
There are a variety of bibs available and range in size (large or small), colour (blue, beige or white) and fastening (tie, Velcro, pull cord). These are generally moistened with a fine mist of water to humidify the air you breathe. These products can be simply washed and reused a number of times prior to disposal. 3. Baseplates and Cassettes
Baseplates
These are available in a variety of different sizes (round, oval, convex) colours (white, clear, beige) and with different strengths of adhesive (e.g. optiderm, normal, regular, flexiderm etc.) depending on what they are being used for. It is fitted over the stoma, almost like a plaster and various attachment then ‘click’ on to it. This speech and language therapist and nursing staff will advise you which baseplate to use. These baseplates usually last 24- 48 hours although they may need to be changed sooner in the early days. Cassettes
The cassette ‘clicks’ on to the baseplate. It contains a foam filter which is responsible for filtering, warming and moistening inhaled air and side vents which prevent ‘sucking up’ against clothing, bed linen etc. There are also different levels of resistance dependent on whether you are a new laryngectomee and need to get used to the system; carrying out active sports or an established user. If you have a voice prosthesis fitted the button of the filter can be depressed to enable an airtight seal so air is shunted through the valve and enables the laryngectomee to speak. Shower Protection
It is really important that laryngectomees do not allow water to enter the stoma when showering etc. It is reported that only a tablespoon (15mls) of water entering the stoma is enough for a laryngectomee to drown. If a patient uses a baseplate there is a ‘shower aid’ available that ‘clicks’ onto the baseplate. A strong adhesive baseplate should be worn when showering and we recommend the ‘flexiderm oval’. However if you do not use the baseplate system there are a number of aprons available that can also be worn to protect the stoma (020). They simply fasten around the neck using Velcro. Servox
Immediately following your operation you will be issued with an electrolarynx (servox) by your speech and language therapist. Please click here for some more information on an electrolarynx. Voice Prosthesis
If you are fitted with a voice prosthesis (valve) this will be fitted by the Doctors at the hospital and involves a small operation. They will need to be changed periodically. Valves come in many different varieties – they are generally changed by a clinician at the hospital but for some models you can be taught to self change. However if you have one of these fitted it is important that it is cleaned regularly – you will be issued with brushes, pipettes etc and shown how to do this by the speech and language therapist and/or nursing staff. |
