Laryngectomy
Definition
A laryngectomy is a full or partial removal of the voice box (larynx).
Reasons for Procedure
This surgery is done to treat cancer of the voice box. It may also be done to treat trauma to the voice box.
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Infection
- Blood clots
- Damage to nearby structures
- Problems speaking
- The need for repeat surgery
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
Anesthesia
General anesthesia will be used. You will be asleep.
Description of the Procedure
An incision will be made in the skin on the neck. The muscles that are attached to the voice box will be separated. The voice box and tissue around it will be removed.
A partial laryngectomy may be done. The doctor will remove only part of the voice box. This will allow for some normal speech and swallowing.
An opening called a stoma will be made from the outside of the neck to the windpipe. This is called a tracheostomy. It will allow for breathing.
Drainage tubes will be inserted to drain blood and fluid. The incisions will be closed. Bandages will be placed over the area.
How Long Will It Take?
5 to 9 hours
Will It Hurt?
Pain and swelling are common in the first 1 to 2 weeks. Medicine and home care can help.
Average Hospital Stay
The usual length of stay is 7 to 14 days. You may need to stay longer if you have problems.
Post-procedure Care
At the Hospital
Right after the procedure, the staff may:
- Give you pain medicines
- Teach you how to care for the stoma
- Arrange for speech therapy to learn new ways to communicate
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your risk of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
It will take about a month to recover. Physical activity will be limited during recovery. You will need to ask for help with daily activities and delay return to work.
Call Your Doctor
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, excess bleeding, or discharge from the incision
- Nausea or vomiting
- Pain that you cannot control with medicine
- Problems breathing
- Swallowing problems
- Eating problems
- Stoma is getting smaller
- Saliva is leaking through the incision
If you think you have an emergency, call for medical help right away.
RESOURCES:
American Cancer Society
https://www.cancer.org
National Cancer Institute
https://www.cancer.gov
REFERENCES:
Chow LQM. Head and Neck Cancer. N Engl J Med. 2020 Jan 2;382(1):60-72.
Laryngeal and hypopharyngeal cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/laryngeal-and-hypopharyngeal-cancer.html. Accessed December 7, 2020.
Management of head and neck cancer—based on cancer site. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-head-and-neck-cancer-based-on-cancer-site. Accessed December 7, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Marcin Chwistek, MD Last Updated: 4/21/2021