Laryngectomy

What is a laryngectomy?

A laryngectomy is surgery to remove all or part of your larynx (voice box). Your larynx sits just above your trachea (windpipe) and connects your mouth and nose to your lungs. It plays a key role in breathing, swallowing and speaking.

Your healthcare provider may recommend a laryngectomy if your voice box is severely damaged or diseased. Common reasons include:

• Laryngeal cancer
• Irreversible injury or trauma to your larynx

You may need a partial laryngectomy (removing part of the larynx) or a total laryngectomy (removing all of it).

Fewer people need laryngectomies now than they did years ago. That’s because fewer people smoke, and healthcare providers have new ways to treat your throat without removing your voice box.

How should I prepare for a laryngectomy?

Before surgery, your healthcare provider will do a physical exam and may order tests like:

• A chest X-ray to check your lungs
• An EKG to check your heart rhythm
• Blood tests

You’ll also meet with specialists like speech-language pathologists (SLPs) and swallowing therapists who’ll help you prepare for recovery and life after surgery.

If you smoke, your team may help you quit. You might also meet with a dietitian to talk about an eating plan after surgery.

Before your surgery day, your care team will give you instructions. Most people need to stop blood thinners. You may also need to stop eating and drinking the night before.

What happens during a laryngectomy?

You’ll be asleep under general anesthesia. Here’s what your surgeon will do:

• Make an incision: They’ll cut into the front of your neck.
• Remove your voice box: They may remove part or all of it, including vocal cords. Nearby lymph nodes or throat tissue might also come out.
• Create a stoma: This is a new opening in your neck to help you breathe. A tube goes into the stoma.
• Place a voice prosthesis (optional): If you’re getting one, the surgeon makes a small hole between your windpipe and esophagus to place it.
• Close the incision: They’ll close the cut with stitches.

What happens after this surgery?

You’ll stay in the hospital for one to two weeks. At first, you’ll get food through a tube. Once it’s safe to swallow, your team will help you eat by mouth again.

What are the risks or complications?

Like any surgery, this one has risks. These can include:

• Damage to nearby organs, like your windpipe or esophagus
• Fistulas (abnormal openings between your throat and skin)
• Limited neck or shoulder movement
• Low thyroid function (can affect your energy and metabolism)
• Stoma problems like irritation or care difficulties
• Trouble eating, swallowing or speaking — especially at first

What is the recovery time?

Most people need two to three weeks to recover from this surgery. It may take longer depending on your surgery and how fast you heal.

What should I know about post-total laryngectomy care?

This surgery often removes cancer, but you might still need treatments like radiation or chemotherapy.

You’ll learn new ways to breathe, eat and talk. A speech therapist will help with communication. You’ll also learn how to care for your stoma — the new breathing hole in your neck.

Follow all post-surgery instructions from your provider. They’ll help you heal and adjust.

Can you speak after a laryngectomy?

After a laryngectomy, you’ll need to find new ways to communicate. Because the surgery removes your vocal cords, your voice will sound different. But with support from a speech-language pathologist, you can learn to speak again. Several tools and techniques can help.

Voice prosthesis

This small device fits over your stoma. It lets air from your lungs move into your throat to create vocal sound. Your healthcare provider can help decide if this is right for you.

Electrolarynx

This is a device you hold against your neck. It makes vibrations to help you speak. The voice sounds robotic, but it’s easy to learn.

The voice sounds robotic, but it’s a reliable option for communication after surgery.

Esophageal speech

This method uses air trapped in your throat to make sound. It takes time to learn, but it doesn’t need any devices.

Nonverbal communication

You may also:

• Learn sign language
• Type on a phone or tablet
• Use gestures or facial expressions
• Write thoughts down

When should I call my healthcare provider?

Call your provider if you develop a fever, pus around your incision or other signs of infection after your laryngectomy.

If you have chest pain or trouble breathing, call 911 (or your local emergency number) or go to the emergency room right away.