What is the problem?

Head and neck cancer patients, often have to undergo a tracheostomy, where a prosthetic device is fitted to help maintain their airway. In the same way as the devices used in larynx replacement, this device is also colonised by micro-organisms leading to infection and further complication. As with the voice prosthesis scenario there is no current management pathway and devices are simply removed and discarded “in case” there is any potential colonisation. The potential outcomes and successes of this are therefore identical to those achieved by the voice prosthesis MDT. In addition, the new technology being developed for voice prosthesis management is expected to apply to other airway management devices.

There is no centralised documentation of total numbers of people affected by a tracheostomy in the UK but that at the present time around 20 patients are admitted routinely (between 2-8 weeks) to the East Kent Hospitals team for replacement of the prosthesis in relation to head and neck cancer. This is probably similar in number to the voice prosthesis cohort but the devices themselves are much more expensive and the risk to patients of infection is high. 

The number of incidences that require a similar prosthesis that is not related to head and neck cancer is of course much larger and would be regarded as an added benefit of the approach. Efforts will be targeted at a small and defined group of cancer patients which will allow close monitoring with a view to developing technology and procedure that will help a much larger group of patients. This may also include other cancer groups, for example lung cancer patients, who require intubation. This would not be a direct or feasible target of our study, but we would pave the way.

What will this project cost Kent Cancer Trust?

Starting in the academic year beginning September 2017, Kent Cancer Trust will cover half the cost of funding a PhD student to work on this problem. We expect this to cost around £36,000 over a 3 year period.

The effect of Covid-19 on this work programme

Covid-19 had a significant impact on this project as the University of Kent's laboratories were closed from March 2020 during the lockdown period and NHS hospital activities were essentially focussed on treating patients with covid-19 rather than providing input to the tracheostomy project .

It was only in 2022 that the covid-19 control measures wererelaxed sufficiently to enable the   necessary delivery of samples from the hospitals to begin again and the University's laboratories  to restart the project. Given the success of the larynx project, the project team remains quietly confident that the trachea project will  achieve similar success.

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