Laryngectomy

A laryngectomy is surgery to remove your larynx (voice box). This surgery is used to help treat cancer of the larynx, thyroid, or other throat cancers. After surgery, you will breathe through an opening in your neck called a stoma. You may have a total or partial laryngectomy depending on how much of your larynx needs to be removed.

How do I prepare for surgery?

• If you have not stopped smoking, you will need to stop permanently at least several weeks before surgery. You will meet with several specialists to help you understand changes that will happen after surgery. A counselor may help you prepare mentally and emotionally for the changes that will happen from the surgery. A speech therapist will help you understand what your voice will sound like after surgery. The therapist will also help you understand changes to the way you breathe and swallow.
• You may need to stop taking certain medicines days or weeks before surgery. Your healthcare provider will tell you which medicines to take or not take on the day of surgery. Take these medicines with a sip of water. You may be given antibiotics through your IV to prevent a bacterial infection. Tell the healthcare provider if you have ever had an allergic reaction to antibiotics.
• Ask someone to stay with you after surgery. The person can help with daily activities and can talk to emergency responders if needed.

What will happen during surgery?

• You will be given general anesthesia to keep you asleep and free from pain during surgery.
• Your surgeon will make an incision in your neck. Some or all of your larynx will then be removed. You may need to have lymph nodes or part of your pharynx removed because of cancer. Your pharynx connects your nose, larynx, and lungs.
• A stoma will be placed in the front of your neck. This will be a small hole about the size of a nickel. You may also have a tracheoesophageal puncture (TEP). The TEP will allow an artificial voice box to be placed so you can speak.
• The incision will be closed with stitches.

What will happen after surgery?

• You may need to stay in the intensive care unit (ICU) for a few days after surgery. This will help your healthcare providers monitor your recovery closely. You will move to a hospital room when you are strong enough to recover.
• Oxygen will be given through your stoma after surgery. A plastic tube called a tracheostomy tube may be placed below the incision to help protect your airway. The tube is used for a short time and is removed when you do not need it anymore. If you had a total laryngectomy, you will have a permanent tracheostomy. You will use a trach tube or a stoma cover to keep the tracheostomy open.
• You will need to be fed through a feeding tube until your surgery wounds heal. A feeding tube may be guided into your nose and down to your stomach. A tube may instead be inserted into your stomach through a hole in your abdomen.
• You will be taught how to care for your stoma and laryngectomy tube, and how to suction mucus. Healthcare providers may also teach a friend or family member so that person can help you at home.

What should I expect after surgery?

• You may have drains around your neck. These are tubes that drain extra fluid from the wound for a few days.
• You may need to write on a notepad for several days after surgery. This is because you will not be able to speak right away.
• You may feel depression or sadness because of the changes from surgery. Counselors, family, friends, or your spiritual leader can help you. It is important for you to have emotional support and encouragement.
• You will have a scar on your neck that loops from one ear to the other. Over time, the scar should fade.
• Surgery will permanently change the way you swallow, talk, and breathe. You will also have changes in the your sense of smell.
• You will not be able to swim after you have this surgery. You will have a higher risk for drowning because of the stoma.

What are the risks of a laryngectomy?

You may bleed more than expected or develop an infection. Other parts of your esophagus or trachea may be damaged during surgery. A hematoma (collection of blood) may form around blood vessels. You may have breathing problems if your trachea is damaged during surgery. You may develop a fistula (abnormal connection between your pharynx and skin). The stoma may become tight. If you have a TEP, it may stark to leak. You may also develop problems with swallowing or speaking. Changes in your sense of smell may make it difficult to smell smoke or other harmful chemicals.