Laryngectomy

Definition

Laryngectomy is surgery to remove the larynx (voice box) in your throat. All or part of the larynx may be removed in a laryngectomy.

Alternative Names

Complete laryngectomy; Partial laryngectomy

Description

Total laryngectomy is major surgery that is done in the hospital. Before surgery you will receive general anesthesia. This will make you unconscious and unable to feel pain.

In a total laryngectomy, first your surgeon will make an incision (cut) in your neck to open up the area. Important parts of this surgery are:

• Your surgeon may remove the lymph nodes.
• Your surgeon may do a tracheoesophageal puncture (TEP). A TEP is a small hole made in your trachea (wind pipe) and esophagus (the tube that moves food from your throat to your stomach). Your surgeon will place a small prosthesis (a man-made part) into this opening. The prosthesis will allow you to speak after your voice box has been removed.
• Your surgeon will remove your larynx and the tissues around it.
• Your surgeon will make an opening in your trachea and a hole in front of your neck. Your trachea will be brought up and attached to this hole. The hole is called a stoma. After surgery you will breathe through your stoma. It will never be removed.
• Your muscles and skin will be closed with stitches or clips. You may have tubes coming from your wound for a while after surgery.

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

• These may work for some people. The surgery you have may depend on how much your cancer has spread and what type of cancer you have.
• The names of some of these less invasive procedures are endoscopic (or transoral resection), vertical partial laryngectomy, horizontal or supraglottic partial laryngectomy, and supracricoid partial laryngectomy.

Part of your pharynx may be removed in a total laryngectomy. Your pharynx is the tube air moves through from your nose. It connects with your larynx.

The surgery takes 5 to 9 hours.

Risks

Risks for any surgery are:

• Allergic reactions to medicines
• Breathing problems
• Heart problems
• Bleeding
• Infection

Risks for this surgery are:

• Hematoma (a buildup of blood outside the blood vessels)
• Wound infection
• Fistulas (tissue connections that form between the pharynx and the skin that are not normally there)
• The stoma opening may become too small or tight. This is called stomal stenosis.
• Leaking around the tracheoesophageal puncture (TEP) and prosthesis
• Damage to other areas of the esophagus or trachea
• Problems swallowing and eating
• Problems speaking