Skip to main content Accessibility help

The use of inhalers in patients with tracheal stomas or tracheostomy tubes

  • S. Mirza (a1), L. Hopkinson (a1), T. H. Malik (a1) and D. J. Willatt (a1)


Patients with chronic obstructive airways disease (COAD) or asthma who have a tracheostomy tube or tracheal stoma have difficulty using metered dose inhalers (MDIs) because of a failure to achieve a good seal between the tracheostomy tube or stoma and the MDI or spacer device mouthpiece. Many such patients therefore utilize nebulizers. MDIs in comparison to nebulizers have the advantages of being more compact, portable, easy to use, less time-consuming, and cheaper. We present the case of a 74-year-old man who underwent a laryngectomy with tracheal stoma formation who had a poor response with nebulizers and required oral steroids. He was subsequently, with the help of a number of attached devices, able to use his MDIs to good effect. We describe a number of devices and adaptors to enable patients with laryngectomy stomas or tracheostomy tubes to utilize MDIs and undergo respiratory function tests. We recommend that all such patients should have the benefit of a consultation with a dedicated respiratory nurse who can provide the appropriate MDIs, devices and adaptors to optimize the treatment of their lower respiratory tract condition.


Corresponding author

Address for correspondence: Mr S. Mirza, 7 Cemetery Road, Royton, Oldham OL2 5SP.


Hide All
Davidson, R. N., Hayward, L., Pounsford, J. C., Saunders, K. B. (1986) Lung function and within-breath changes in resistance in patients who have had a laryngectomy. Quarterly Journal of Medicine 60: 753762.
Meeker, D. P., Stelmach, K. (1992) Modification of the spacer device: use in the patient with arthritis or an artificial airway. Chest 102: 12431244.
Nakhla, V. (1997) A homemade modification of a spacer device for delivery of bronchodilator or steroid therapy in patients with tracheostomies. Journal of Laryngology and Otology 111: 363365.
Newman, S. P., Woodman, G., Clarke, S. W., Sackner, M. A. (1986) Effect of InspirEase on the deposition of metered dose aerosols in the human respiratory tract. Chest 89: 551556.
O'Callaghan, C., Dryden, S., Cert, D. N., Gibbin, K. (1989) Asthma therapy and a tracheostomy. Journal of Laryngology and Otology 103: 427428.
Storr, J., Lenney, C. A., Lenney, W. (1986) Nebulised beclomethasone dipropionate in preschool asthma. Archives of Disease in Childhood 61: 270273.
Webb, M. S. C., Milner, A. D., Hiller, E. J., Henry, R. L. (1986) Nebulised beclomethasone dipropionate suspension. Archives of Disease in Childhood 61: 11081110.
Weber, P. A., Brown, A. R. (1984) The use of a conical spacer after laryngectomy. British Medical Journal 288: 1537 (letter).


The use of inhalers in patients with tracheal stomas or tracheostomy tubes

  • S. Mirza (a1), L. Hopkinson (a1), T. H. Malik (a1) and D. J. Willatt (a1)


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed