{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:40:27Z","timestamp":1792086027206,"version":"4.4.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T00:00:00Z","timestamp":1602547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>It is impossible to secure the airway of a patient with \u201cneck\u2010only\u201d breathing transorally or transnasally. Surgical removal of the larynx (laryngectomy) or tracheal rerouting (tracheoesophageal diversion or laryngotracheal separation) creates anatomic discontinuity. Misguided attempts at oral intubation of neck breathers may cause hypoxic brain injury or death. We present national data from the American Academy of Otolaryngology\u2013Head and Neck Surgery, the American Head and Neck Society, and the United Kingdom\u2019s National Reporting and Learning Service. Over half of US otolaryngologist respondents reported instances of attempted oral intubations among patients with laryngectomy, with a mortality rate of 26%. UK audits similarly revealed numerous resuscitation efforts where misunderstanding of neck breather status led to harm or death. Such data underscore the critical importance of staff education, patient engagement, effective signage, and systems\u2010based best practices to reliably clarify neck breather status and provide necessary resources for safe patient airway management.<\/jats:p>","DOI":"10.1177\/0194599820960728","type":"journal-article","created":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T12:30:35Z","timestamp":1602592235000},"page":"1040-1043","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Oral Intubation Attempts in Patients With a Laryngectomy: A Significant Safety Threat"],"prefix":"10.1002","volume":"164","author":[{"given":"Michael J.","family":"Brenner","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Medical School University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Cramer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine Wayne State University Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan A.","family":"McGrath","sequence":"additional","affiliation":[{"name":"National Tracheostomy Safety Project, National Health System Manchester UK"},{"name":"Anaesthesia and Intensive Care Medicine Manchester University NHS Foundation Trust Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine Stanford University Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katelyn O.","family":"Stepan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Feinberg School of Medicine Northwestern University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinciya","family":"Pandian","sequence":"additional","affiliation":[{"name":"Society of Otorhinolaryngology and Head\u2010Neck Nurses School of Nursing Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Roberson","sequence":"additional","affiliation":[{"name":"Bayhealth Medical Group Milford Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul K.","family":"Shah","sequence":"additional","affiliation":[{"name":"Children\u2019s National Medical Center Washington, DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Winship Cancer Institute School of Medicine Emory University Atlanta Georgia USA"},{"name":"Department of Epidemiology Rollins School of Public Health Emory University Atlanta Georgia USA"},{"name":"Department of Health Policy and Management Rollins School of Public Health Emory University Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itzhak","family":"Brook","sequence":"additional","affiliation":[{"name":"Georgetown University Washington, DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Nussenbaum","sequence":"additional","affiliation":[{"name":"American Board of Otolaryngology\u2013Head and Neck Surgery Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14798"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14709"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27500"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814521985"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23926"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817723897"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.04.003"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22453"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suronc.2009.05.005"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2010.07.022"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812438170"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.03.004"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820949528"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1201\/9781315376592"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2012.07217.x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489420920324"},{"key":"e_1_2_10_18_1","volume-title":"Emergency Algorithm: Laryngectomy","author":"National Tracheostomy Safety Project","year":"2020"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12177"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.04.064"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.04.054"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599820960728","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599820960728","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599820960728","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:56:49Z","timestamp":1760961409000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599820960728"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,13]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1177\/0194599820960728"],"URL":"https:\/\/doi.org\/10.1177\/0194599820960728","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,13]]},"assertion":[{"value":"2020-07-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}