Partial Laryngectomy
A partial laryngectomy is the surgical removal of a portion of the larynx, or the voice box. This procedure is usually done for patients with cancer of the larynx. A partial laryngectomy may be possible versus a total laryngectomy, depending on the extent of the cancer. With the partial laryngectomy you may retain some normal speech and more of your normal swallowing function.
The partial laryngectomy is possible when the lesion is found at an early stage. 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.
Due to the localized swelling with this procedure, a temporary tracheotomy (for about 5 days) is required to maintain an adequate airway. The goal is to start gradually weaning you off the tracheotomy tube before discharge. You will have a feeding tube initially after surgery. You will have a swallow evaluation to assess your ability to safely eat and drink. Depending on the results of your evaluation, you will slowly progress to soft foods. After surgery, you will have a drain in your incision, which prevents fluid and blood from building up in the wound. The drain will be removed when the drainage is minimal.
Risks
As with any surgical procedure, there are risks and possible complication involved. Some possible complications include:
- Allergic reactions to medicines
- Breathing difficulties
- Infections
- Bleeding
- Excessive swelling
- Blood clots
- Injury to the trachea (windpipe) or esophagus
- 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
- 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.
- Please notify us of all routine medications and significant health history. Take medications as directed with just a sip of water.
- 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)
- If you have diabetes, ask your doctor if you need to adjust your medications.
- Remove all make-up, jewelry, nail polish, and artificial nails before your surgery.
- Do not bring valuables to the hospital (cash, credit cards, watches, jewelry, etc.)
- 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: You will have a scar in the form of a stoma (hole) in your neck. Unlike a total laryngectomy your stoma and incision will minimize over time and eventually have little to no scarring. 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:
- Swelling, excessive bleeding or discharge from the incision site
- Signs of infection
- Fever above 101° F and
- Pain not relieved by pain medication as prescribed
- Any other worrisome symptom
- 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.
- Cough, shortness of breath, or chest pain.
- Any other worrisome symptoms