What does this research mean for the field?

Patients with a tracheostomy or total laryngectomy face high risks of life-threatening airway emergencies that require prompt anatomical identification, appropriate equipment, and structured protocols to prevent harm. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To review the identification, management, and prevention of acute perioperative airway emergencies in patients with surgically altered airways.

September 3, 2026Current Opinion in Anaesthesiology

Airway emergencies in patients with laryngectomy and tracheostomy

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Authors

SMS. Nini MalayamanUniversity of Pennsylvania JMJames E. MirandaUniversity of Pennsylvania

Discussion

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Implication

Clinical review reports a 26% mortality rate from oral intubation attempts in laryngectomy cases, highlighting the need for structured protocols and simulation training during airway emergencies.

Key Points

To review the identification, management, and prevention of acute perioperative airway emergencies in patients with surgically altered airways.
Review of clinical evidence and national registry data assessing intraoperative airway complications, equipment selection, and surgical stoma distinctions in patients with tracheostomy or total laryngectomy.
Registry data indicate a 26% mortality rate when clinicians erroneously attempt oral intubation in total laryngectomy patients.
Life-threatening complications frequently involve tube obstruction, accidental decannulation, hemorrhage, endobronchial tube migration, circuit disconnection, and inadvertent cannulation of tracheoesophageal puncture tracts.
Implementation of structured algorithms, cognitive aids, multidisciplinary quality improvement initiatives, and simulation-based training provides measurable reductions in adverse airway events.

Cite This Study

Malayaman et al. (2026) studied this question.

synapsesocial.com/papers/6a9bd3358680cd2c758506e6 https://doi.org/10.1097/aco.0000000000001706

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Implication

Clinical review reports a 26% mortality rate from oral intubation attempts in laryngectomy cases, highlighting the need for structured protocols and simulation training during airway emergencies.