What is a breathing stoma?

When you might have a breathing stoma

Whether you will have a breathing stoma depends on the:

• position of your cancer

• size of your cancer

• type of surgery you have

You can see when and how you might have a breathing stoma in our surgery section. 

Read more about when and how you might have a stoma

Types of breathing stomas

You might have a temporary or a permanent stoma. Your doctor can tell you which type of stoma you need.

Temporary stoma

A temporary stoma is when you keep your voice box after surgery and this hole is temporary. It is also called a tracheostomy. The stoma is held open by a tracheostomy tube. You might have this:

• after surgery to the voice box

• after radiotherapy, if you have swelling around your voice box

You keep the tracheostomy until the voice box heals. Then, the tracheostomy tube is taken out and the hole heals up by itself. This may take about 1 to 2 weeks, but for some people it can take longer.

Permanent stoma

After having your whole voice box removed, you have a permanent stoma to breathe through. The hole is a different shape from a tracheostomy. You might hear this called a laryngectomy stoma or neck stoma.

You need this stoma because the connection between your windpipe and mouth has been closed. Your surgeon makes the stoma when you have surgery to remove your voice box.

You usually have a stoma tube in place for a while. This is to maintain the size and shape of the stoma. You might have this for up to a few months.

Image showing the normal flow of air

Image showing the flow of air after a laryngectomy stoma

Stoma tubes

There are several different types of stoma tubes. The type you have depends on whether your stoma is temporary or permanent.

Most tubes are plastic. Some have an inflatable sleeve around the outside, called a cuff. When the cuff is blown up, it creates a complete seal around your stoma. You only need this seal if you’re on a breathing machine (ventilator) straight after your operation. If you have this type of tube, your nurse changes it to a tube without a cuff a day or two after your surgery.

Changing and cleaning your stoma tube

The plastic tubes are disposable, but you can use them for a while before you throw them away. Your speech and language therapist will let you know how long you can use a tube for. It's important you change and clean them frequently.

Before you go home your nurse and speech and language therapist will talk to you about how to care for the tubes and your stoma. For example, how often you should clean them and how to carefully remove crusting or mucus from your stoma. They will also provide any equipment needed to do this.

Speaking with a stoma

Laryngectomy and tracheostomy tubes can have a small opening in the side of the tube. Tubes with a side opening like this are called fenestrated tubes. Tubes without an opening are called non fenestrated tubes.

You use a fenestrated tube to be able to speak. To do this, you put your finger over the hole at the end of the tube when you speak.

If you have a ​tracheostomy, the air is forced up through the side opening and through your voice box to create a voice. If you have had your voice box removed, the air is forced up through the side opening and through a speech valve. 

Speech valve (prosthesis)

A speech valve is also called a trachea oesophageal prosthesis. To have this valve, your surgeon makes an opening between your windpipe and food pipe (oesophagus). Surgeons can sometimes do this at the same time as a laryngectomy. Or you can have it at a later time. Exhaled air can be forced through the valve. By covering the stoma with a finger as you breathe out, you make sounds. 

You will have a lot of help from your speech and language therapist and nurses to help support you and your family and friends while you learn how to do this.  

This type of surgery is not suitable for everyone. Your surgeon will talk to you about the risks and benefits and let you know if this is suitable for you. 

Read more about speaking after a laryngectomy

When your stoma has healed

Not everyone needs to have a tube once the stoma has healed. Your surgeon is the best person to advise you on this.

Read about looking after your breathing stoma