Dry-powder inhaler alternatives for chronic obstructive pulmonary disease patients post total laryngectomy.

OBJECTIVES: Patients undergoing total laryngectomy who have chronic obstructive pulmonary disease are unable to use dry-powder inhalers due to the anatomical changes after surgery and are therefore at greater risk of post-operative pulmonary complications. In our practice, we identified a scarcity of resources available to help clinicians decide on a suitable alternative. Hence, we sought to provide a solution that would address this issue.

METHODS: Within our head and neck centre, we worked with the respiratory team and specialist pharmacists to create a simple conversion table to help clinicians identify alternatives to dry-powder inhalers.

RESULTS: A table was designed that shows which metered-dose inhalers when connected to a spacer and an infant face mask overlying the laryngeal stoma can be used.

CONCLUSION: Our table can be used as a resource by clinicians to improve the perioperative and long-term care of patients who cannot use dry-powder inhalers.