What is a breathing stoma?

A stoma is a hole (opening) made in the skin in front of your neck to allow you to breathe. It is at the base of your neck. Through this hole, air enters and leaves your windpipe (trachea) and lungs.

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

Whether you will have a breathing stoma depends on the:

• position of your cancer
• size of your cancer
• type of surgery you have

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.

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, so your clinical nurse specialist or your doctor might call this a laryngectomy 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.

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 2 after your surgery.

The plastic tubes are disposable, but you can use them for a while before you throw them away. Your healthcare team will let you know how long you can you a tube for. It's important you change them frequently and clean them. There is a risk of developing an infection if they are not cleaned regularly. Your specialist nurse and speech and language therapist will show you how to do this.  

Some tubes are single, others have an outer and inner tube. These are called dual or double cannula tubes. 

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 your speech valve. 

If you have a speech valve, you might want to use a hands free tube later on. This automatically closes the stoma when you use it. This means you don't have to put your hand up to cover the hole when you want to say something.

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.