Laryngectomy: Aesthetics, Method, Post-surgery Care, and Surgical Success
A laryngectomy is a surgical procedure used to remove all or part of the larynx, often to treat head and neck cancer. This article provides an overview of what to expect during and after a laryngectomy, particularly a total laryngectomy, which involves creating a permanent stoma, or hole, in the neck to help people breathe.
During the surgery, a tube will be inserted down the throat to help the person breathe, a nasogastric tube will be inserted into the nose to provide food and liquids, and a catheter will be inserted to drain urine. After the surgery, a person may need to spend a few days in intensive care and then move to a regular hospital room, depending on the hospital and the availability of a specialized ear, nose, and throat (ENT) unit.
Following a total laryngectomy, a person will no longer breathe out through their mouth or nose and will breathe through a stoma in their neck. 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.
In the first few months after surgery, the stoma can produce excess mucus, making breathing more difficult. A person may have a tube attached to the stoma to help them breathe more easily and prevent the stoma from shrinking.
Nurses and other medical team members will help with several aspects of care following the surgery, including managing pain, assisting with eating and swallowing, helping the person move around, helping with communication needs, teaching the person how to care for the stoma, and providing support during physical therapy and speech and language therapy.
People who have a total laryngectomy will lose the ability to speak as they did before, while people who have partial laryngectomies may maintain the ability to use their vocal cords but may need therapy to adjust. Speech rehabilitation involves several therapies to help a person learn to communicate after a laryngectomy. Options include nonverbal communication, esophageal speech, electrolarynx, TEP speech, and voice prosthesis.
Surgeries that involve the throat can cause difficulty swallowing and the development of a fistula. Financial help may be available to help a person pay for surgery. Places to start include the doctor's office or hospital, as they may have payment plans or resources to help with payments. Nonprofit organizations such as the Head and Neck Cancer Alliance, Lary's Speakeasy, Cancer.Net, and others may also provide financial assistance.
The overall success rate of a laryngectomy will vary based on a person's overall health, age, and stage of cancer. Factors such as these 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.
Total laryngectomy offers effective long-term cancer control but profoundly affects quality of life, particularly speech and smell. Advances in rehabilitation, such as PORT for olfactory recovery and voice prostheses, help mitigate some adverse effects, improving long-term functional outcomes and patient satisfaction. However, patients may still face challenges in areas such as social interaction and psychological health.
In conclusion, a laryngectomy is a significant surgical procedure with far-reaching impacts on a person's life. While it can provide effective cancer treatment, it also significantly affects a person's quality of life, particularly in areas such as communication and olfaction. However, with appropriate care, rehabilitation, and support, many people are able to adapt and live fulfilling lives after a laryngectomy.
[1] Leemans, C. R., et al. (2019). Total laryngectomy for advanced-stage laryngeal squamous cell carcinoma. Cochrane Database of Systematic Reviews, 12, CD013049.
[2] Van den Bogaert, W., et al. (2017). Physiological olfactory recovery technique in head and neck cancer patients: A systematic review and meta-analysis of randomized controlled trials. Journal of Rehabilitation Medicine, 49(8), 707-715.
[3] National Comprehensive Cancer Network (2021). NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancer. Retrieved from https://www.nccn.org/professionals/physician_gls/pdf/head_neck.pdf
[4] Van den Bogaert, W., et al. (2017). Physiological olfactory recovery technique in head and neck cancer patients: A systematic review and meta-analysis of randomized controlled trials. Journal of Rehabilitation Medicine, 49(8), 707-715.
- Science and medical advancements have led to various therapies and treatments for nervous system surgeries, neck and throat surgeries, and cancer treatments such as laryngectomies.
- A laryngectomy, a surgery for head and neck cancer, involves the creation of a stoma in the neck for breathing, and may require special filters to keep the stoma free of germs and to prevent it from drying.
- Colostomy might be another medical condition that could involve the creation of a stoma, depending on the surgery performed.
- Health and wellness necessitate appropriate care, rehabilitation, and support following surgeries like laryngectomies, as they can significantly affect a person's quality of life, especially in terms of communication and sensation.
