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Laryngectomy


Why is this procedure done?


The larynx is also called the voice box. It is a hollow tube that makes sounds when we speak. It houses the vocal cords that help us talk with each other. It also acts like a door that lets air in and keeps food out of the lungs. ‚  
When doctors remove part of or the whole larynx, it is a laryngectomy. You may need to have this done: ‚  
  • To take out a tumor
  • To get rid of a narrow area
  • If the voice box is very badly hurt because of trauma or disease

Doctors perform this procedure using different methods. You may or may not be able to talk in the same way after the surgery. This is based on the kind of procedure you have. Your doctor may need to do a: ‚  
  • Total laryngectomy ¢ ˆ ’ The doctor takes out the larynx and other things like muscle and lymph nodes. You will not be able to speak in the same way after this surgery. You will need to have a hole in your neck to breathe.
  • Partial laryngectomy ¢ ˆ ’ The doctors will remove only a part of your larynx. You may have a hoarse or weak voice after surgery. You will be able to breathe normally.
  • Supraglottic ¢ ˆ ’ Removes the part of the larynx above the voice box. You will be able to speak normally after surgery. You will be able to breathe normally.

If you have cancer in your larynx, talk to your doctor about treatment. You may need surgery, radiation, and drugs. ‚  


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What will the results be?


The doctor will remove the damage or cancer in your larynx. Your signs will disappear or will improve. ‚  

What happens before the procedure?


  • Your doctor will take your history. Talk to your doctor about:
    • All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
    • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
    • If you need to stop eating or drinking before your procedure.
  • Your doctor will do an exam and may order:
    • Lab tests
    • X-rays
    • Ultrasound
  • The doctor will talk to you about tools that will help you speak even if your larynx has been removed.
  • You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.

What happens during the procedure?


  • Once you are in the operating room, you will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. The staff will put an I.V. in your arm to give you fluids and drugs.
  • When you are asleep, the doctors put a tube in your mouth to help you breathe. They also put another small tube in your nose. This one goes down to your stomach to drain out any food or fluid that might come out during surgery. Your doctor will put a tube in your bladder to drain urine.
  • Your doctor will clean your neck with an antiseptic. Your doctor will make a cut that will expose your larynx. Your doctor will cut the damaged larynx out. Your doctor may also take out other structures like the lymph nodes and tissues around it.
  • The windpipe at the end of the larynx is attached to the skin of your neck. This makes a hole called a stoma. It is where a tube that will help you breathe will go. The tube is called a tracheostomy.
  • Your doctor will close the muscles and skin with stitches. Your doctor will put the tracheostomy tube into the stoma.
  • Your doctor may also put in a device that will let you to speak after laryngectomy. Your doctor will talk with you about this before the surgery.
  • The procedure takes 5 to 9 hours.

What happens after the procedure?


  • You will go to the Recovery Room and the staff will watch you closely. You may have to stay in the hospital for 2 to 4 days.
  • You may spend a night in the Intensive Care Unit for close watching by nurses and doctors.
  • There will be a tube on your neck. This tube will help you breathe.
  • You will have discomfort and numbness in your neck after the procedure. This may become more painful when the anesthesia wears off. Your doctor will give you drugs for this.

What care is needed at home?


  • Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
  • Learn how to care for your tracheostomy. You will need to know how to suction any fluids in your lungs. Ask how to change the tube and what to do in case of an emergency.
  • Talk to your doctor about how to care for your cut site. Ask your doctor about:
    • When you should change your bandages
    • When you may take a bath or shower
    • If you need to be careful with lifting things over 10 pounds
    • When you may go back to your normal activities like work or driving
  • Be sure to wash your hands before and after touching your wound or dressing.
  • Learn how to use communication tools. Then, you will be able to talk with other people with ease.
  • Take extra care to avoid water or small elements like foods bits, dust, powders, and sprays from getting into your trach tube.
  • Cover your trach tube with light clothing or scarves when going outdoors.

What follow-up care is needed?


  • Your condition needs close monitoring. Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
  • If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
  • Your doctor may send you to a speech therapist to help you learn ways to talk with other people, even with a trach.

What lifestyle changes are needed?


Practice what your doctor or speech therapist taught you after you get home from therapy sessions. ‚  

What problems could happen?


  • Bleeding
  • Infection
  • Loss of voice
  • Nerve injury
  • Injury to other structures near the larynx
  • Low mood
  • Anxiety
  • Pneumonia

Where can I learn more?


American Cancer Society ‚  
http://www.cancer.org/Cancer/LaryngealandHypopharyngealCancer/DetailedGuide/laryngeal-and-hypopharyngeal-cancer-treating-surgery ‚  
Cancer Research UK ‚  
http://cancerhelp.cancerresearchuk.org/type/larynx-cancer/treatment/surgery/which-surgery-for-laryngeal-cancer ‚  
http://cancerhelp.cancerresearchuk.org/type/larynx-cancer/living/speaking-after-laryngectomy ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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