A neck stoma describes an opening in the neck that a person breathes through. A surgeon may perform this procedure if someone requires surgery to remove tissue in the neck. In some cases, this may be necessary if a person develops cancer due to smoking.

A neck stoma, also known as a breathing stoma, refers to a surgical hole present on the front of the neck. This can occur due to surgically creating a hole, separating tissues in the neck, or removing tissue. As this procedure can disrupt how a person may breathe, a doctor may leave a permanent neck stoma, which will allow the individual to breathe.

While someone with a history of smoking may require a stoma, not all neck stomae occur due to smoking.

In this article, we will discuss tracheostomy and laryngectomy procedures, including why someone may require one and what the procedures involve.

A person with a neck stoma-1.Share on Pinterest
PongMoji/Getty Images

The term stoma, or ostomy, refers to a surgical opening that doctors make in the skin. A surgeon may perform an ostomy procedure when a health issue is not allowing a part of the body to function correctly.

A tracheostomy, also known as a tracheotomy, is a procedure to help oxygen reach the lungs by making an opening into the windpipe, or trachea, on the neck. In some cases, a surgeon may place a small plastic tube in the opening to help a person breathe. When a surgeon removes the tube, the opening can heal naturally. However, depending on how long it has been in place, a person may require surgical closure.

A laryngectomy is a procedure to remove the larynx, or voice box. If a surgeon removes the whole larynx, it means there is no longer a connection between the mouth, nose, and lungs. This means a person will require a permanent opening in the windpipe to breathe. A person may also need to learn other ways to communicate after a laryngectomy.

Typically, a person may require a breathing stoma when there is a problem with the upper airway that prevents air from getting into the lungs. Someone who smokes may require a stoma if they develop a type of cancer that affects their airways.

Smoking tobacco is a leading cause of cancer. It can result in different types of cancer, including:

Tobacco can result in this disease due to the chemicals present in tobacco products. These chemicals can weaken the body’s immune system and damage or change a cell’s DNA. This can cause cells to grow out of control, which may lead to cancer.

As such, a person may experience damage to their trachea, larynx, or higher up in the airway due to cancer treatment. In these cases, a doctor may perform an ostomy procedure to help them breathe.

A breathing stoma can be either temporary or permanent, depending on the reason for the procedure. A person may require a temporary stoma if there is an expectation that the cancer treatment may damage the upper airways.

However, if a surgeon needs to remove tissue due to cancer, the individual may require a permanent stoma. For example, if they need a total laryngectomy to remove the entire larynx, they will require a permanent stoma in the front of the neck to allow them to breathe.

In addition to an opening in the neck, other types of stoma include:

  • Colostomy: An opening using part of the colon, or large intestine, to bypass the rectum.
  • Urostomy: An opening in the belly that redirects urine away from a bladder.
  • Ileostomy: An opening that diverts the small intestine through an opening in the belly.
  • Tympanostomy: A tube that creates an airway in the middle ear to prevent the accumulation of fluids behind the eardrum.
  • Gastrostomy: A surgical opening through the skin of the abdomen to the stomach.

If a doctor thinks that other options, such as radiation therapy or larynx-preserving surgeries, will be ineffective for treating cancer, they may perform a total laryngectomy.

To perform a laryngectomy, a surgeon will:

  • insert a tube down the throat to help the person breathe
  • insert a nasogastric tube into the nose to provide food and liquids during the surgery and a catheter to drain urine
  • make an incision above the Adam’s apple and remove the necessary tissue
  • create a small opening, known as a stoma, to allow a person to breathe directly through this opening

Before a person leaves the hospital, they will receive information about the stoma and how to care for it. This may vary slightly between tracheostomy and laryngectomy stomae. The healthcare team will instruct a person to:

  • clean the skin around the stoma
  • cough and clear any mucus
  • use a suction tube to remove mucus if necessary
  • protect the skin surrounding the stoma

An individual can take this opportunity to ask the healthcare team questions. This can include the best way to clean the stoma, how to best wear a humidification device to cover the stoma, and if they should avoid activities such as swimming.

The healthcare team should also provide a suggested routine to help look after the stoma and discuss the equipment a person may need to look after it.

Proper care of a stoma is important to help prevent potential complications, which can include:

  • bleeding
  • stomal stenosis
  • peristomal skin irritation
  • stomal crusting
  • airway obstruction
  • voice prosthesis dislodgement

Pharyngocutaneous fistula and voice prosthesis dislodgement complications do not occur with tracheostomy and are specific for laryngectomy.

A neck stoma refers to a surgical opening in the front of the neck that allows a person to breathe. A doctor may perform a stoma procedure following complications from cancer affecting the airways. However, smoking is not the only reason someone may require a neck stoma.