Laryngectomy is a procedure to remove a part of, or all of, the larynx. A person may need this procedure to remove tumors from the larynx.
A surgeon may perform a partial laryngectomy and remove part of the larynx, or a total laryngectomy and remove the entire larynx.
This article reviews what a laryngectomy is, types, what to expect, and more.
A laryngectomy is a surgical procedure used to remove all or part of the larynx, also known as the voice box. Surgeons perform this surgery to treat head and neck cancer.
A person may also require a laryngectomy to treat chronic aspiration, a condition where people repeatedly breathe food or drink into the lungs. However, this is usually a
Types
There are several different types of laryngectomies. Each type involves making an incision above the Adam’s apple to access the larynx.
Types of laryngectomies
- Partial: This is a treatment option for smaller tumors. A surgeon removes a part of the larynx. The goal is to remove the cancer while leaving as much of the larynx intact as possible.
- Supraglottic: This is a type of partial laryngectomy. It involves the removal of the top part of the larynx above the vocal cords. Surgeons will perform this procedure to treat supraglottic cancers. A person can speak as they usually do following this type of procedure.
- Hemilaryngectomy: Another type of partial laryngectomy, this procedure involves removing one of the two vocal cords to remove small cancers. Depending on how much of the larynx the surgeon removes, a person may or may not be able to talk after this procedure.
- Total: A total laryngectomy involves removing the entire larynx. A surgeon will also create a permanent stoma, or hole, in the neck to help people breathe. A person will be able to eat and drink as usual, but they will lose their ability to speak and need to learn new ways to communicate.
The United Kingdom’s National Health Service (NHS) notes that partial laryngectomies are uncommon. Surgeons typically prefer performing an endoscopic resection. This is another procedure to treat early-stage laryngeal cancer.
Vs. tracheostomy
A tracheostomy is a procedure that places a stoma in the trachea. It provides people direct access to their trachea and lungs to allow them to breathe through a tube.
If a surgeon removes a person’s entire voice box, they will require a permanent stoma. Healthcare professionals will call this a laryngectomy stoma. A laryngectomy stoma is not the same as a tracheostomy.
After a total laryngectomy, the surgeon brings the trachea to the skin of the neck. This means there is no connection to the airways as the connection between the windpipe and the mouth is no longer there.
A laryngectomy treats cancers of the throat, such as laryngeal and hypopharyngeal cancers.
A doctor
- there is severe trauma to the larynx
- the cancer is advanced
- the cancer has not responded to chemotherapy or radiation therapy
- the tumor is large
- a person has chronic aspiration or no voice as a result of palsy of the cranial nerves
- a person has recurrent laryngeal papillomatosis
The neck contains many components. Two important components include the larynx and trachea, and the esophagus.
The larynx and trachea connect to the lungs, while the esophagus connects to the stomach and the rest of the gastrointestinal tract.
The larynx shares a space in the neck with the esophagus known as the pharynx. This is where both pipes connect to the mouth.
A total laryngectomy removes the connection between the mouth and the trachea, which means a person will no longer breathe out their mouth or nose. Following the procedure, the trachea and esophagus will no longer share the same space.
Instead, a person will breathe through a stoma or hole in their neck. They
People may need therapy to help them account for the changes in the neck’s anatomy.
Partial laryngectomies leave more of the structure in place.
According to the
- pneumonia
- blood clots
- infections
- complications from anesthesia
Surgeries that involve the throat can cause:
- difficulty swallowing, which can affect how a person eats
- the development of a fistula
- the rupture of the large veins or arteries, although this is very rare
People who have a total laryngectomy will lose the ability to speak as they did before.
People who have partial laryngectomies will usually maintain the ability to use their vocal cords, though they may need therapy to help them adjust to any changes following the surgery.
Before the procedure, a doctor will likely order several tests to help assess a person’s risk factors for complications.
People with poor wound healing, such as from smoking or previous radiation therapy, may have a
The doctor’s office, hospital, or both, may provide detailed instructions on preparing for the procedure.
This may include instructions on:
- what medications to stop taking and when
- when a person should stop eating or drinking
- instructions for the facility
- other instructions that are important for the person’s safety
During the surgery, the surgical team will work with an anesthesiologist to keep the person asleep throughout the procedure.
Once asleep, the surgical team will insert:
- a tube down the throat to help the person breathe
- a nasogastric tube into the nose to provide food and liquids during the surgery
- a catheter to drain urine throughout the procedure
They will then make an incision above the Adam’s apple and perform the removal of all or part of the larynx.
Once they have removed what they need, they will create a stoma in the trachea. This is an opening that will allow the person to breathe directly through the hole.
The NHS states that the stoma may be temporary if a person is undergoing a partial laryngectomy and permanent if they are undergoing a total laryngectomy.
However, a permanent stoma may be necessary for some partial laryngectomies. A doctor will be able to let a person know if they require a temporary or permanent stoma.
They will then use stitches or staples to close the neck back up.
Following the procedure, nurses will monitor the person in a recovery room.
The NHS states that a person may need to spend a few days in intensive care after a total laryngectomy. The person will then move to a regular hospital room.
However, this is dependent on the hospital. In places with a specialized ear, nose, and throat (ENT) unit, they may be able to go straight to a regular hospital room.
A person will also be unable to eat until their throat has healed, which can take 1–2 weeks. During this time, a person will be tube fed through the nose and into the stomach.
During the stay, a nurse or other medical team will help with several aspects of care. This can include:
- helping to manage pain
- assisting with eating and swallowing
- helping the person move around
- helping with communication needs, such as providing a dry erase board
- teaching the person how to care for the stoma
The person will need to get up and move around their room. This helps prevent complications from the surgery and blood clots. A person may then start physical therapy and speech and language therapy.
A person may require additional treatments, such as chemotherapy or radiation therapy, depending on the extent of the tumor.
Stoma care
In the first few months after surgery, the stoma can produce excess mucus. This can make breathing more difficult.
In these cases, a person may have a tube attached to the stoma is help them breathe more easily. It also helps prevent the stoma from shrinking, and a person can remove the tube to remove mucus.
A doctor will remove the tube once the stoma stops producing too much mucus.
People will need to clean the stoma once a day to help prevent it from becoming crusty and infected. A nurse will teach a person how to clean their stoma.
To help keep the stoma free of germs and to prevent it from drying, a doctor may provide a person with special filters.
People should cover the stoma with a tissue when coughing or sneezing. This is because mucus and saliva will come from the stoma instead of the mouth or nose.
Speech rehabilitation
Speech rehabilitation involves several different therapies to help a person learn to communicate.
Some options include:
- Nonverbal communication: This can include everything from facial expressions and pointing to using whiteboards and markers or other assistive devices.
- Esophageal speech: This technique can be difficult to learn and involves trapping air and using the air, tongue, and lips to make a vibration and form words.
- Electrolarynx: This is a device placed against the neck that creates a robotic-sounding voice.
- TEP speech: This is a type of speech that uses a tracheoesophageal puncture to place a voice prosthesis that allows a person to speak.
- Voice prosthesis: This is an artificial valve that a surgeon will implant into the neck. When a person wants to speak, they will cover the stoma and breathe through the valve. This then produces a noise that a person can use to make words using their lips and mouth. The voice may be a lower pitch than a person’s previous voice.
After treatment, a person may require emotional support. People may consider:
- speaking with family members and friends
- seeking counseling
- finding support groups
People may find the following resources useful:
ACS patient programs and services - Cancer Survivors Network
- CancerCare
- National Cancer Institute’s booklet,
“Life After Cancer Treatment”
A person’s overall outlook is good for people recovering from a laryngectomy.
Some studies point out that about
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Survival rates following a laryngectomy can vary greatly. Factors such as age, overall health, stage of cancer, and others can affect how long a person can expect to live following the procedure.
A doctor may be able to provide a better estimate based on a person’s individual situation.
Financial help may be available to help a person pay for surgery. One place to start is with the doctor’s office or hospital. They may have payment plans or resources to help with payments.
A person may also find that nonprofit organizations may help, including:
A laryngectomy is a procedure that treats certain throat cancers. There are two main types: total and partial.
A person who undergoes a total laryngectomy will lose their ability to speak as they did before. They will also need a stoma or opening created in the neck to help them breathe.
The overall success rate of the procedure will vary based on a person’s overall health, age, and stage of their cancer.