Laryngectomy

Alternative Names: Complete laryngectomy; Partial laryngectomy

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

Description of Procedure

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

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

• Your surgeon may remove the lymph nodes.
• 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.
• Your surgeon may do a tracheoesophageal puncture (TEP). A TEP is a small hole in your windpipe (trachea) and the tube that moves food from your throat to your stomach (esophagus). Your surgeon will place a small man-made part (prosthesis) into this opening. The prosthesis will allow you to speak after your voice box has been removed.

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

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

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 of Laryngectomy

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

Review Date: 2/28/2011
Reviewed By: Seth Schwartz, MD, MPH, Otolaryngologist, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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