Your larynx, also called the voice box, helps you to breathe, eat and speak. A laryngectomy is a surgical procedure for the removal of all or part of the larynx (voice box). This is done most frequently to remove cancer that affects the larynx.
Types of laryngectomy
There are several types of laryngectomies, including:
Partial laryngectomy removes part of the larynx and is used for smaller tumors. Though there are several kinds of partial laryngectomy surgeries, the intended outcome is the same: to remove only a portion of the larynx (the entire cancerous part) so that as much of the larynx is left intact as is feasible.
Supraglottic laryngectomy removes some of the larynx located above the vocal cords. You may still maintain your normal speaking voice after a supraglottic laryngectomy.
Hemilaryngectomy is a treatment for small cancers of the vocal cords. It involves the removal of one vocal cord while maintaining the others. You’re able to speak after a hemilaryngectomy, but it’s more limited.
Total laryngectomy takes out the larynx completely. It affects your ability to speak normally, although it’s possible to learn to speak in other ways, such as with a mechanical voice or esophageal speech training.
Your doctor chooses which laryngectomy to perform, depending on the location of the cancer and the throat cancer stage.
How it’s done
A laryngectomy requires anaesthesia and takes about five to nine hours to perform.
The surgeon begins the procedure by making incisions in your neck through which he or she will remove your larynx. Lymph nodes and part of your pharynx may also be removed, depending on the underlying cause of your laryngectomy. Lymph nodes are part of your immune system and located throughout your body. They help fight infection, but they can also be affected by cancer.
Your pharynx is the common space in the back of your throat where your nasal passages, mouth, upper esophagus, and your larynx all meet. Treatment for cancer of your pharynx might involve partial removal of your pharynx. This is called a pharyngectomy.
After removing the larynx, the doctor will create the stoma, a permanent hole about the size of a nickel in the front of the trachea. It links directly from the outside to your lungs so you can breathe.
Some people who have laryngectomies also have a tracheoesophageal puncture (TEP) performed. By going through the stoma, a small hole is created in both the trachea and the esophagus. This can be done at the time as the laryngectomy surgery or during a second procedure afterwards. Something must always remain in place within the TEP in order to keep it open.
Once the surgery is complete, your throat muscles and the skin on your neck will be closed with surgical stitches. You might have drainage tubes placed in your neck before you’re taken to the recovery room. The tubes drain the surgical site of fluids and blood for several days after a laryngectomy.
Physical Recovery After A Laryngectomy
Most laryngectomy patients spend the first couple of days after surgery in the intensive care unit (ICU). Your doctors will closely monitor your blood pressure, heart rate, breathing, and other vital signs. You’ll receive oxygen through your stoma right after surgery.
You won’t be able to eat through your mouth while your throat heals. A feeding tube that runs from your nose to your stomach or that’s inserted directly into your stomach will provide you with nutrition. Your neck will be swollen and painful. You’ll receive pain medication as needed.
When your condition stabilizes, you’ll move to a regular hospital room. Expect to stay in the hospital for roughly two to three weeks after surgery. During this time, you’ll continue to heal, learn how to swallow again, and begin to learn how to communicate without your larynx.
Follow any instructions given by your care team to help you heal. Your doctor and nurses will encourage you to move around to prevent blood clots, decrease the risk of pneumonia, and help you get accustomed to your stoma and new ways of breathing. Getting up and out of bed is important for recovery. You may receive physical therapy, as well as speech and language therapy. You may also be advised to avoid heavy lifting and strenuous activity for six weeks.
Your care team helps teach you how to take care of your stoma laryngectomy tube. You also learn how to speak again with the help of a speech therapist.