Laryngectomy

Laryngectomy is removal of the voice box (larynx). Your larynx is located at the top of your throat. It allows you to speak. A laryngectomy may be necessary if you have cancer, injury, or radiation damage of the larynx.

A laryngectomy involves making a surgical cut (incision) in the front of your neck and removing your larynx. Some lymph nodes in the area may also be removed. After having a laryngectomy, you will no longer be able to breathe out of your mouth. Your surgeon will make a new opening (stoma) in the front of your neck. After your surgery, you will breathe through the stoma.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to food or medicine.

  • Medicines you are taking, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Difficulty with numbing medicines or anesthesia during previous surgeries.

  • History of bleeding problems or blood clots.

  • Previous surgeries.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy, if this applies.

RISKS AND COMPLICATIONS

  • Allergies to medicines.

  • Difficulty breathing.

  • Bleeding.

  • Infections.

  • Damage to other structures near the larynx.

  • Difficulty swallowing.

  • Difficulty speaking.

  • Difficulty with your stoma.

BEFORE THE PROCEDURE

  • Stop smoking if you smoke. Stopping will improve your health after surgery.

  • You may have blood tests to make sure your blood clots normally. You may be asked to stop taking blood thinners (anticoagulants) or nonsteroidal anti-inflammatory drugs.

  • Do not eat or drink anything for at least 8 hours before your surgery.

  • Talk to your caregiver about taking your regular medicines, such as high blood pressure medicine, on the morning of your surgery.

PROCEDURE

  • An intravenous (IV) access tube will be put into one of your veins in order to give you fluids and medicines.

  • You will receive medicines to relax you and medicines that make you sleep (general anesthetic).

  • You may have a flexible tube (catheter) put into your bladder to drain urine.

  • You may have a tube put through your nose or mouth into your stomach (nasogastric tube). The nasogastric tube removes digestive fluids and prevents you from feeling sick to your stomach (nauseous) and throwing up (vomiting).

  • Usually, a U-shaped incision is made, which begins under one side of your jawbone (beneath your ear) and continues down just below your voice box and up to the other side of the jawbone.

  • The larynx is separated from the windpipe (trachea) and removed.

  • The stoma will be made at the bottom part of the incision.

  • The new opening to the trachea will be sewn so that it opens up into the stoma.

  • The external incisions will be closed with stitches, staples, or surgical glue.

AFTER THE PROCEDURE

  • You will wake up in a recovery room, resting in bed until you have fully returned to consciousness.

  • You will have some pain. Pain medicines will be available to help you.

  • Your temperature, breathing rate, heart rate, blood pressure, and oxygen level will be monitored regularly.

  • You may be admitted to a special intensive care unit in the hospital for 1 to 2 days, where you can be closely monitored.

  • The head of your bed will be kept at an upright angle.

  • You will have a humidified oxygen mask over your stoma.

  • You may have a nasogastric tube.

  • You may have multiple tubes that drain fluid from the incision.

  • You will have a tube that drains your bladder (catheter).

  • At first, you will not be able to swallow your saliva. A suction tube will be used to remove saliva from your mouth and to keep your lungs clear of secretions.

  • You will continue to receive fluids through an IV tube.

  • You may have compression stockings on your legs to prevent blood clots.

  • You will be taught some breathing exercises. These will help your lungs recover from the anesthesia.

  • Since you will not be able to speak, you may have a whiteboard to write on or a picture board you can point to.

  • When you are more stable, you will be transferred to a regular hospital room.

  • You will probably be in the hospital for 2 to 3 weeks. During this time, various drains, tubes, and monitors will be removed when they are no longer needed. Also, you will be slowly eased into more activities, swallowing your own saliva, and learning some alternate ways of communication with the help of a variety of therapists.

  • An enterostomal therapist will help you learn how to care for your stoma.