Introduction
After total laryngectomy, the changes in the physiology of the tracheal
epithelium due to the direct passage of air through the stoma, the loss
of nasal warming and humidification and the impairment of the
mucociliary clearance may increase the risk of lower respiratory tract
infections 1. In retrospective studies, the incidence
of lower respiratory tract infections in laryngectomees was, in fact,
considerably higher compared to that of adults of the same age2. Among these, tracheitis represents a challenging
condition, commonly requiring urgent management and hospitalization, as
it can be complicated by significant crusting and recurrent occlusion of
the airway.
Total laryngectomy patients represent a unique challenge during the
SARS-CoV-2 pandemic. On one hand, they have a potential higher exposure
to the contagious nature of SARS-CoV-2 through respiratory droplets and
aerosols and a high risk of mortality due to the elderly age,
respiratory comorbidities and immunodepression 3. On
the other hand, they carry a high risk of transmitting viral particles
to health care staff through the tracheostoma.
Herein we describe the clinical features of a series of patients,
previously subjected to total laryngectomy, who contracted SARS-CoV2 and
developed severe tracheitis, focusing on its management, clinical course
and histologic features.