How to Suction Your Laryngectomy Stoma

After a total laryngectomy, you breathe through an opening in your neck called a stoma instead of through your nose and mouth. Suctioning the stoma area helps keep your airway clear. This helps you breathe safely and comfortably.

Your airways still make mucus and other secretions. Before surgery, you would cough these up through your mouth. Now they collect around or inside your stoma and windpipe (trachea).

It's important to suction your stoma to:

• Remove mucus and secretions that you can’t cough out.
• Keep your airway open and clear.
• Make it easier to breathe.
• Help prevent serious breathing problems, including a blockage.

Thick mucus can partly or fully block your airway. This can be dangerous. Regular suctioning reduces this risk.

Suction as often as your doctor tells you to do. You may need to suction when:

• You hear or feel mucus “rattling” in your airway.
• It feels harder than usual to breathe.
• You can’t clear secretions by coughing.
• You see mucus at the stoma opening.

Most people suction several times a day in the early weeks after surgery.

You may need to suction more often if you:

• Have a cold or other respiratory infection.
• Have more or thicker mucus.
• Live in a dry environment.
• Feel congested.

Suctioning should not be painful, but it may feel:

• Uncomfortable.
• Like pressure in your airway.
• Tickly.
• Like you need to cough or gag.

Coughing during suctioning is normal. You may see small amounts of blood in your mucus as you suction. If you feel sharp pain, stop and contact your doctor.

You will need these items:

• Suction machine
• Suction tubing
• Sterile suction catheter (correct size as instructed)
• Mirror
• Sterile saline (if prescribed)
• Tissues or gauze

Keep your supplies in a clean, convenient place.

Clean hands help prevent infection. Wash your hands with soap and clean running water for at least 20 seconds. Dry your hands with a clean towel. If you don’t have clean water, use hand sanitizer gel or wipes with at least 65% alcohol. If you don’t have sanitizer, wear disposable nitrile gloves.

1. Turn on the suction machine.
2. Make sure the suction pressure is set as directed by your doctor.
3. Connect the suction tubing to the machine.
4. Attach the sterile suction catheter to the tubing.
5. You can test the suction by putting a small amount of saline in the catheter tip and gently covering the suction control port.

1. Sit upright in a comfortable position.
2. Place the mirror in front of you so you can see your stoma.
3. If instructed, you may place a few drops of sterile saline into the stoma to help loosen thick mucus before suctioning.
4. Gently insert the suction catheter into your stoma. Do not force it. Insert it until you feel a slight resistance or you begin to cough.
5. Apply suction by covering the suction control port.
6. Slowly rotate and pull out the catheter while suctioning.
7. Limit each suction pass to 10 seconds or less. Otherwise, you may feel short of breath.
8. Rest and take several deep breaths between passes.
9. Repeat if needed, allowing time to recover between attempts.

1. Turn off the suction machine.
2. Disconnect and get rid of the catheter (if it's single-use).
3. If you have reusable equipment:
   • Wash tubing and containers with warm, soapy water.
   • Rinse thoroughly.
   • Allow to air dry completely.
4. Throw away used tissues (and gloves if you used them).
5. Wash your hands.

Follow your doctor’s instructions for how often to replace the tubing and catheter.

Call 911right away if:

• You have trouble breathing that doesn’t get better after suctioning.
• You cough up blood. (A small amount of blood when suctioning is okay.)

Contact your doctor now if:

• You have thick mucus that’s hard to remove.
• You have yellow, green, or foul-smelling mucus.
• You have a fever.
• There is worse swelling, redness, or pain around the stoma.
• You have to suction much more often than usual.
• There is a sharp pain when you suction.

If you have questions or feel unsure about the process, contact your care team. They are there to help you breathe safely and comfortably.