Laryngectomy

Definition

Laryngectomy is surgery to remove all or part of the larynx (voice box).

Alternative Names

Complete laryngectomy; Partial laryngectomy

Description

Laryngectomy is major surgery that is done in the hospital. Before surgery you will receive general anesthesia. You will be asleep and pain-free.

Total laryngectomy removes the whole larynx. Part of your pharynx may be taken out as well. Your pharynx is the mucous membrane-lined passage between your nasal passages and esophagus.

The surgeon may also do a tracheoesophaheal puncture (TEP).

There are many less invasive surgeries to remove part of the larynx.

The surgery can take 5 to 9 hours.

Why the Procedure Is Performed

Most often, laryngectomy is done to treat cancer of the larynx. It is also done to treat:

Risks

Risks for any surgery are:

Risks for this surgery are:

Before the Procedure

You will have medical visits and tests before you have surgery. Some of these are:

Always tell your health care provider:

During the days before your surgery:

On the day of your surgery:

After the Procedure

You will need to stay in the hospital for several days after surgery.

After the procedure, you will be groggy and will not be able to speak. An oxygen mask will be on your stoma. It's important to keep your head raised, rest a lot, and move your legs from time to time to improve blood flow. Keeping blood moving reduces your risk of getting a blood clot.

You can use warm compresses to reduce pain around your incisions. You will get pain medicine.

You will receive nutrition through an IV (a tube that goes into a vein) and tube feedings. Tube feedings are given through a tube that goes through your nose and into your esophagus (feeding tube).

You may be allowed to swallow food as soon as 2 to 3 days after surgery. However, it is more common to wait 5 to 7 days after your surgery to start eating through your mouth.

Your drain may be removed in 2 to 3 days. You will be taught how to care for your laryngectomy tube and stoma. You will learn how to safely shower. You must be careful not to let water enter through your stoma.

Speech rehabilitation with a speech therapist will help you relearn how to speak.

You will need to avoid heavy lifting or strenuous activity for about 6 weeks. You may slowly resume your normal, light activities.

Follow up with your provider as you are told.

Outlook (Prognosis)

Your wounds will take about 2 to 3 weeks to heal. You can expect full recovery in about a month. Many times, removal of the larynx will take out all the cancer or injured material. People learn how to change their lifestyle and live without their voice box. You may need other treatments, such as radiotherapy or chemotherapy.

References

Agrawal N, Goldberg D. Primary and salvage total laryngectomy. Otolaryngol Clin North Am. 2008;41(4)771-780. PMID: 18570958 www.ncbi.nlm.nih.gov/pubmed/18570958.

Rassekh H, Haughey BH. Total Laryngectomy and laryngopharyngectomy. In: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Head and Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 110.

Romesser PB, Riaz N, Ho AL, Wong RJ, Lee NY. Cancer of the head and neck. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 68.