Medical Oncologist
CION Cancer Clinics
Tracheostomy and laryngectomy stoma are not the same thing | CION Cancer Clinics
A tracheostomy and a laryngectomy stoma both leave an opening in the front of the neck, but they are different. With a tracheostomy the voice box stays and the windpipe is still joined to the mouth and nose. With a laryngectomy the voice box is removed, and the neck opening becomes the only airway for life. That changes speech, smell and, above all, emergency care. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Is a tracheostomy the same as a laryngectomy stoma?
- How do they differ day to day?
- What does each one mean for speaking, smell and swallowing?
- How can you tell which one someone has?
- What mix-ups cause problems?
- Which one might you need, and what can this page not tell you?
- Common questions about tracheostomy and laryngectomy
The short answer
Is a tracheostomy the same as a laryngectomy stoma?
No. With a tracheostomy the voice box stays, and the windpipe is still joined to the nose and mouth above the tube. With a laryngectomy the voice box is removed, and the neck opening becomes the only way air can reach the lungs.
What a tracheostomy is
A small opening is made in the front of the windpipe and a tube is placed through it. Air can often still pass up past the tube to the voice box, nose and mouth. Many tracheostomies are temporary, and the hole closes once the tube comes out.
What a laryngectomy stoma is
A laryngectomy is an operation to remove the voice box, usually for a cancer of the voice box or the lower throat. The top of the windpipe is then brought forward and stitched to the skin of the neck. That opening is called a stoma. The windpipe no longer connects to the mouth or nose at all, so the stoma is permanent and cannot be closed.
Both openings sit in the same place on the neck and can look alike. The difference is what lies behind them.Side by side
How do they differ day to day?
Tracheostomy
Laryngectomy stoma
Voice box still in place
Voice box removed
Some air may still reach the nose and mouth
All breathing is through the neck
Always has a tube in the opening
May have no tube, or a soft short one for a time
Often temporary and can close
Always permanent
Speech often possible with a speaking valve
A new way of speaking has to be learned
What changes
What does each one mean for speaking, smell and swallowing?
These are the questions families ask most once they realise the two are different.
Speaking
With a tracheostomy, the natural voice can often be used once air is let up past the tube. After a laryngectomy there are no vocal cords, so a new voice is learned.
Options after laryngectomy
- A small valve placed between windpipe and food pipe
- A hand-held electronic voice device
- Speech using swallowed air
Smell and taste
Smell works by drawing air through the nose. After a laryngectomy that no longer happens, so smell, and with it taste, is dulled. A therapist can teach a technique that helps. A tracheostomy affects smell far less.
Swallowing
A tracheostomy tube can make swallowing harder, and food may slip towards the airway. After a laryngectomy food and air take separate routes, but the new throat may feel tight and swallowing therapy is often needed.
Water and bathing
Both need care, because water entering the opening goes straight to the lungs. After a laryngectomy this risk is lifelong. Swimming is not safe without special equipment and training.
Not sure whether this applies to you?
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!
The one thing every carer and emergency worker must know
If someone with a neck opening is struggling to breathe, oxygen and rescue breaths must go to the opening in the neck. After a laryngectomy, a mask over the mouth and nose does nothing at all. With a tracheostomy, give oxygen to both the neck and the face. Call for emergency help at once, say the person breathes through their neck, and carry an emergency card that says which one they have.
Knowing which one
How can you tell which one someone has?
Check the discharge summary
The operation name is written there. The word laryngectomy, total or partial, tells you the voice box was touched. Tracheostomy alone means it was not removed.
Ask about the voice box
Ask the team one simple question: was the voice box removed? The answer settles it, and it is worth writing on the emergency card.
Look for a tube and plate
A tracheostomy always has a tube with a flat plate held by ties. A laryngectomy stoma is often a bare, rounded opening, although some people wear a soft tube in it.
Never test by blocking it
Do not cover the opening to see if the person can breathe through the mouth. After a laryngectomy they cannot, and covering it stops all breathing.
Commonly believed
What mix-ups cause problems?
"A hole in the neck is a hole in the neck. The care is the same."
Much of the daily care is similar, but the emergency steps are not. Knowing which one you are caring for changes where oxygen goes and whether the mouth can be used at all.
"After a laryngectomy, the stoma can be closed later like a tracheostomy."
It cannot. There is no longer a connection between the windpipe and the mouth. The stoma is the airway for life.
"Without a voice box, speech is gone for good."
Many people speak again after a laryngectomy, using a voice valve, an electronic device or swallowed air. It takes practice with a speech therapist, and progress varies from person to person.
"Having a tracheostomy means the voice box will be removed next."
A tracheostomy is often done to protect the airway during other treatment. It does not mean a laryngectomy is planned. Ask your team what the overall plan is.
Being straight with you
Which one might you need, and what can this page not tell you?
This page cannot tell you which operation suits you. Whether a tracheostomy, a laryngectomy or neither is advised depends on where the cancer is, its stage, what treatment has already been given and how the voice box and swallowing work now. Your treating team weighs all of that.
When the voice box may be kept
For some cancers of the voice box, radiotherapy with or without chemotherapy, or a smaller operation, may be offered to try to keep the voice box. A tracheostomy is sometimes needed along the way to protect the airway. These options do not suit every person, especially when the voice box no longer works well or the cancer is extensive.
Questions to ask
Is the voice box being removed, or only a tube placed? If the voice box is removed, which way of speaking would you suggest for me, and when can I meet a speech therapist? Who will train my family? What goes on my emergency card? These answers shape life at home more than any other.
Questions we are asked
Common questions about tracheostomy and laryngectomy
Can a person with a laryngectomy breathe through the mouth?
No. After the voice box is removed, the windpipe is no longer connected to the mouth or nose. Every breath goes in and out through the stoma in the neck. That is why the stoma must never be covered, and why emergency oxygen must be given to the neck.
Can a person with a tracheostomy breathe through the mouth?
Sometimes, depending on how open the airway is above the tube and whether the cuff is filled. Some air may pass up to the nose and mouth. But when a tube has been placed because the airway is narrow, the neck tube is still the main and safest route.
Does a laryngectomy stoma always have a tube in it?
Not always. Some people wear a soft short tube or a button in the stoma for a time after surgery, or during radiotherapy, to stop it narrowing. Many people later have no tube at all and cover the stoma with a light filter or cloth.
Will I lose my voice with a tracheostomy?
The voice box stays, so the voice is not removed. Speaking may be hard at first, especially if the cuff is filled. Once it is safe to let air past the tube, a speaking valve often helps. If the voice box itself is affected by a tumour, the voice may still be weak.
Why is my smell weaker after a laryngectomy?
You smell by drawing air in through the nose, and after a laryngectomy air no longer flows that way. Food can taste flat for the same reason. A speech therapist can teach a mouth and throat movement, sometimes called polite yawning, that pulls air through the nose and often helps.
What should go on an emergency card?
Write whether the person has a tracheostomy or a laryngectomy, that they breathe through the neck, where oxygen must be given, the tube type and size if there is one, and a contact number for the family and treating team. Keep one in the wallet and one at home.
Is bathing different for each one?
The principle is the same: keep water out of the neck opening. Use a hand shower aimed below the neck, a shower shield or a damp cloth for the neck. After a laryngectomy this care is lifelong, because any water entering the stoma goes directly to the lungs.
Is the operation covered by Aarogyasri or insurance?
When it is part of approved cancer treatment, both operations are usually covered. Aarogyasri, CGHS, ECHS, EHS and most cashless insurers are accepted at CION. Voice valves, filters and home supplies may be paid for separately. Call the helpline to check your own cover before admission.
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Sources
- NHS — Tracheostomy
- Cancer Research UK — Laryngeal cancer
- American Cancer Society — Laryngeal and Hypopharyngeal Cancer
- Macmillan Cancer Support — Head and neck cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Tracheostomy: What It Is and Why It Is DoneThe basics of the tube in the neckTemporary vs Permanent TracheostomyWhen a tracheostomy comes out and when it staysA Printable Tracheostomy Emergency CardWrite down which opening it is before you need toSpeaking With a Tracheostomy: The Speaking ValveHow speech works when the voice box is keptTracheostomyEvery page in this guide
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