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Laryngectomy

A laryngectomy is the surgical removal of all or a portion of the larynx (voice box). This procedure is usually done for patients with cancer of the larynx. The surgery may also be performed to treat damage to the larynx due to trauma. The procedure is done under general anesthesia. The procedure may involve partial or total removal of one or both vocal cords. As a result of the procedure, there will be a change in your voice. The degree of alteration in voice depends on the extent of the disease.

You will have a stoma (hole) in your neck after you wake up from surgery. You will have a drain in your neck and you may or may not have a tracheostomy tube, depending on the extent of your surgery. You will breathe through the tube in your neck. You will not be able to eat for up to 10 days or longer. Therefore, you will require a feeding tube post-operatively, which is usually temporary. The drain prevents fluid and blood from building up in the wound. The drain will be removed when the drainage is minimal. Following surgery, you will need rehabilitation including speech therapy.

Evaluation before surgery will include a medial history and physical exam. The following procedures may be performed prior to surgery: electrocardiogram, chest x-ray, CT scan or MRI, and laboratory blood work.

Risks

As with any surgical procedure, there are risks and possible complication involved with a laryngectomy. The risks and complications involved include:

  • Allergic reactions to medicines
  • Breathing difficulties
  • Infection
  • Bleeding
  • Excessive swelling
  • Hematoma (a build up of blood outside the blood vessel)
  • Injury to the trachea (windpipe) or esophagus
  • Fistulas (tissue connections that form between the pharynx and the skin)
  • Leaking around the tracheoesophageal puncture (TEP) and prosthesis
  • The stoma opening may become too small or tight. This is called stomal stenosis
  • Injury to nerves controlling the lower lip, face, throat, shoulder, tongue, palate, diaphragm and skin sensation are potential risks of this procedure.
  • Complications from anesthesia (The anesthesiologist will discuss the risks involved with you prior to your surgery)
  • Problems swallowing and eating
  • Problems speaking
  • Recurrence of cancer

Before the Procedure

  1. Nothing to eat or drink after midnight the evening before the procedure. This includes all foods, liquids, candy, mints or chewing gum. You may brush your teeth. You will not be able to undergo the surgery if you do not follow these instructions.
  2. Please notify us of all routine medications and significant health history. Take medications as directed with just a sip of water.
  3. A week before surgery, please avoid aspirin, aspirin-containing products, ibuprofen (Advil, Motrin, Aleve) or Vitamin E. Please notify our office if you are on any medications that affect bleeding, such as coumadin or warfarin. Please call our office if you have any concerns about any medications. (585-342-2080)
  4. If you have diabetes, ask your doctor if you need to adjust your medications.
  5. Remove all make-up, jewelry, nail polish, and artificial nails before your surgery.
  6. Do not bring valuables to the hospital (cash, credit cards, watches, jewelry, etc.)
  7. You will be admitted to a surgical unit in the hospital after your procedure.

After the Procedure

Activity: Avoid lifting, bending, and straining after surgery. Your doctor will make you aware of any restrictions you should have while in the rehabilitation process. You will be shown strengthening exercises after the appropriate healing time has elapsed.

Diet: You will be given nutrition through an IV tube in your vein or a feeding tube while in the hospital. A speech pathologist or doctor will assess your ability to swallow. Depending on the results, you will progress to soft foods. You may be allowed to swallow food within 2 to 3 days after surgery, however, it is more common to wait 5 to 7 days.

Wound Care: The hospital staff will educate you on stoma care prior to discharge from the hospital.

Medication: You will be on antibiotic therapy following surgery to prevent infection. If you are having pain, you may need to take pain medication as prescribed and as needed.

Follow-Up: Our office will notify you of the date and time of your follow up appointment.

Please call our office at 585-342-2080 for any of the following:

  1. Swelling, excessive bleeding or discharge from the incision site
  2. Signs of infection
  3. Fever above 101° F
  4. Pain not relieved by pain medication as prescribed
  5. Nausea and/or vomiting that is not controlled with anti-nausea medication (if prescribed), or which persists for more than two days after discharge from the hospital.
  6. Difficulty breathing or painful swallowing
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