Clinical Presentation
Laryngectomized patients often experience tracheal dryness, which can be effectively managed by the application of heat and moisture exchangers, as evidenced by improved humidity levels [PMID:15744172].
Management
The use of preinduction nebulization with ketamine and magnesium sulfate or budesonide has been shown to prevent postoperative complications such as sore throat, hoarseness, and cough [PMID:31567493].
There is conflicting evidence regarding the effectiveness of lidocaine, whether administered topically or intravenously, in preventing laryngospasm [PMID:31567493].
The study demonstrated that application of the HME Prim-Air System led to significant increases in tracheal humidity and temperature within minutes, potentially mitigating tracheal dryness [PMID:15744172].
Complications
Chronic steroid use, particularly inhaled corticosteroids, is associated with an increased risk of laryngeal candidiasis and other rarer fungal infections [PMID:31567493].
Prognosis & Follow-up
Following removal of the HME, tracheal humidity and temperature returned to pre-application levels within 10 minutes, indicating transient but potentially beneficial short-term effects on tracheal health [PMID:15744172].
References
1 Harounian J, Postevka E, Jamal N. Medications and the larynx. Current opinion in otolaryngology & head and neck surgery 2019. link 2 Keck T, Dürr J, Leiacker R, Rettinger G, Rozsasi A. Tracheal climate in laryngectomees after use of a heat and moisture exchanger. The Laryngoscope 2005. link
2 papers cited of 3 indexed.