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.