What is a laryngectomy?
Laryngectomy involves surgically removing the larynx to treat throat cancer. The larynx is the area in the throat where the vocal cords live — it allows you to speak and produce sound. The larynx also protects your lungs by keeping food and drink in the esophagus.
Patients who undergo a laryngectomy may need to learn how to speak, swallow and breathe again after the procedure.
Who is a candidate for a laryngectomy
Your doctor will evaluate your case to determine if you are a candidate for a laryngectomy. You may be a candidate for a full or partial laryngectomy if you have:
- Cancer of the larynx
- A severe injury to the neck
- Radiation necrosis due to radiation treatment
Risks associated with a laryngectomy
A laryngectomy is a major procedure. Complications or side effects that are associated with a laryngectomy include:
- Swelling, bruising at the incision site
- Pain that needs medication
- Numbness that lasts three to four weeks
What to expect during a laryngectomy
During a laryngectomy procedure, your doctor will make an incision in the neck and run it through the soft tissue down to the larynx. Once located, your doctor will remove the larynx. Depending on what is causing your condition, you may also have lymph nodes and part of the pharynx removed.
After the larynx has been removed, your doctor will cut a hole in the front of the trachea that will link your lungs to outside the body. This will allow you to breathe after the airway has been removed. The hole is called a stoma.
Your surgeon will need to implant a voice prosthetic device for you to speak after the procedure. A voice prosthesis is a small device with a one-way valve that reroutes the airflow from the lungs, so you can speak.
Recovery after a laryngectomy
Recovery from a laryngectomy is a lengthy process. You will spend a few days in the Intensive Care Unit (ICU) after surgery, where your vital signs will be closely monitored. You will also need to receive oxygen through a stoma after surgery.
As your throat heals, you will not be eating through your mouth — a feeding tube will run from the nose to the stomach. This tube will provide the nutrition you need until you are able to eat normally again. Your doctor can provide information on how you will eat and what you can eat via the feeding tube.
When your doctor clears you, you will be moved to a regular hospital room and will need to stay in the hospital for 10 to 14 days after surgery. During this time, you will learn to swallow again, learn to communicate without a larynx, be encouraged to move around and may receive physical therapy.
Your ability to talk and or breathe after surgery will depend on how much of your larynx was removed. If the entire larynx is removed, you may need to learn to communicate in other ways and may need a stoma to breathe. A stoma is a hole in the neck that helps you breathe. Patients who have only a small part removed, may be able to talk after the throat has healed.
Patients are advised to stay out of work for six to eight weeks after surgery. You may need more recovery time if you need other treatments such as radiation or chemotherapy.
Once you are discharged, you will be given detailed recovery instructions detailed special for you. Recovery recommendations typically include:
- Rest as much as you can
- Walk each day
- Avoid strenuous activities
- Do not lift anything for six weeks
- Do not drive again until your doctor clears you
- Gradually move from a liquid diet to normal eating over a two-month period
- Follow dosing and timing instructions on all medication you are taking
Regular follow-ups with your doctor are important to monitor for cancer recurrence. Call your doctor if you experience any of the following symptoms while recovering:
- Chest pain, shortness of breath, extreme fatigue, numbness
- Lose consciousness
- Trouble breathing
- Pain that does not improve with pain medication
- Severe bleeding at the incision site
- Signs of infection such as fever, pus drainage from incision, red streaks around incision, increased pain, swelling and redness