Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-27T13:15:20.655Z Has data issue: false hasContentIssue false
  • English
  • Français

The use of inhalers in patients with tracheal stomas or tracheostomy tubes

Published online by Cambridge University Press:  29 June 2007

S. Mirza ,
L. Hopkinson ,
T. H. Malik  and
D. J. Willatt
S. Mirza*
Affiliation:
Department of Otolaryngology, Hope Hospital, Salford Royal Hospitals NHS Trust, Salford, Manchester, UK.
L. Hopkinson
Affiliation:
Department of Otolaryngology, Hope Hospital, Salford Royal Hospitals NHS Trust, Salford, Manchester, UK.
T. H. Malik
Affiliation:
Department of Otolaryngology, Hope Hospital, Salford Royal Hospitals NHS Trust, Salford, Manchester, UK.
D. J. Willatt
Affiliation:
Department of Otolaryngology, Hope Hospital, Salford Royal Hospitals NHS Trust, Salford, Manchester, UK.
*
Address for correspondence: Mr S. Mirza, 7 Cemetery Road, Royton, Oldham OL2 5SP.
Get access Rights & Permissions [Opens in a new window]

Abstract

Patients with chronic obstructive airways disease (COAD) or asthma who have a tracheostomy tube or tracheal stoma have difficulty using metered dose inhalers (MDIs) because of a failure to achieve a good seal between the tracheostomy tube or stoma and the MDI or spacer device mouthpiece. Many such patients therefore utilize nebulizers. MDIs in comparison to nebulizers have the advantages of being more compact, portable, easy to use, less time-consuming, and cheaper. We present the case of a 74-year-old man who underwent a laryngectomy with tracheal stoma formation who had a poor response with nebulizers and required oral steroids. He was subsequently, with the help of a number of attached devices, able to use his MDIs to good effect. We describe a number of devices and adaptors to enable patients with laryngectomy stomas or tracheostomy tubes to utilize MDIs and undergo respiratory function tests. We recommend that all such patients should have the benefit of a consultation with a dedicated respiratory nurse who can provide the appropriate MDIs, devices and adaptors to optimize the treatment of their lower respiratory tract condition.

Keywords

TracheostomyLaryngectomyNebulizers and vaporizersRespiratory function tests
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 8 , August 1999 , pp. 762 - 764
Copyright
Copyright © JLO (1984) Limited 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Davidson, R. N., Hayward, L., Pounsford, J. C., Saunders, K. B. (1986) Lung function and within-breath changes in resistance in patients who have had a laryngectomy. Quarterly Journal of Medicine 60: 753–762.Google ScholarPubMed
Meeker, D. P., Stelmach, K. (1992) Modification of the spacer device: use in the patient with arthritis or an artificial airway. Chest 102: 1243–1244.CrossRefGoogle ScholarPubMed
Nakhla, V. (1997) A homemade modification of a spacer device for delivery of bronchodilator or steroid therapy in patients with tracheostomies. Journal of Laryngology and Otology 111: 363–365.CrossRefGoogle ScholarPubMed
Newman, S. P., Woodman, G., Clarke, S. W., Sackner, M. A. (1986) Effect of InspirEase on the deposition of metered dose aerosols in the human respiratory tract. Chest 89: 551–556.Google Scholar
O'Callaghan, C., Dryden, S., Cert, D. N., Gibbin, K. (1989) Asthma therapy and a tracheostomy. Journal of Laryngology and Otology 103: 427–428.CrossRefGoogle ScholarPubMed
Storr, J., Lenney, C. A., Lenney, W. (1986) Nebulised beclomethasone dipropionate in preschool asthma. Archives of Disease in Childhood 61: 270–273.CrossRefGoogle ScholarPubMed
Webb, M. S. C., Milner, A. D., Hiller, E. J., Henry, R. L. (1986) Nebulised beclomethasone dipropionate suspension. Archives of Disease in Childhood 61: 1108–1110.CrossRefGoogle ScholarPubMed
Weber, P. A., Brown, A. R. (1984) The use of a conical spacer after laryngectomy. British Medical Journal 288: 1537 (letter).Google Scholar