Effectiveness of Bronchodilator Therapy on Dyspnoea After Total Laryngectomy.
Dyspnoea is an important symptom affecting quality of life in the laryngectomy. In these patients, it is useful to conduct spirometry and provide appropriate drug therapy when a bronchial obstruction is present.
The aim of this study was to evaluate the effects of long-term bronchodilators by performing a functional assessment and determining the degree of breathlessness in a group of laryngectomies.
We evaluated 93 outpatient laryngectomies by means of spirometry; the mMRC scale was administered to determine the degree of dyspnoea. When appropriate, we began treatment with bronchodilators according to measured bronchial obstruction and repeated the test after six months of therapy.
Patients undergoing total laryngectomy very often develop clinically evident bronchoconstriction and severe dyspnoea over the long term. In laryngectomies, the prevalence of airway obstruction is high (about 60%) and the incidence of dyspnoea is also very high.
Bronchodilator therapy improved pulmonary function and dyspnoea within 180 days of treatment. The possibility of evaluating and quantifying the degree of obstruction allows optimization of drug therapy.
Patients undergoing total laryngectomy experience a series of physiological changes in breathing pattern caused by the separation of the lower airways from the upper airway, because the air enters through the tracheostoma bypassing the upper respiratory tract, thus eliminating the functions of the nose on the air inhaled, such as heating, humidification, and
filtration.
At the level of the lower airways, this anatomical disruption produces irritation and dryness of tracheo-bronchial mucosa, crusting at the level of the stoma and cough.
Otolaryngol Open J. 2015; 1(1): 2-6. doi: 10.17140/OTLOJ-1-102