Raising airway resistance in laryngctomees incrases tissue oxygen saturation

The physiological airflow resistance from the anterior nares to the upper trachea has recently been documented. ¹This resistance is thought to be important in preventing alveolar collapse and in maintaining the optimum lung ventilation: perfusion ratio.²This resistance is lost in laryngectomees who may have a subsequent decline in lung function and arterial oxygen saturation. A stoma filter with a resistance approximating to that of the normal upper airway has been developed and laryngectomees who wear this device demonstrate a rapid increase in tissue oxygen saturation (median increase: 1.4 kPa, P= 0.0087) without significantly altering tissue carbon dioxide saturation. This finding will have a major impact on the future rehabilitation of laryngectomees and those with a temporary tracheostomy.