After a laryngectomy, if mechanical ventilation is required, where is the endotracheal tube inserted?

• A. Through a tracheostomy site above stoma
• B. Through the nose
• C. Through the mouth
• D. Through the stoma

Answer: (D)

Breathing after a laryngectomy uses a neck stoma that opens directly into the trachea. If mechanical ventilation is needed, the endotracheal tube must be placed through that stoma into the trachea, because the upper airway (nose and mouth) no longer provides a route to the lungs. The stoma route ensures a patent airway for ventilation and is the standard approach in this situation.