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The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on July 12, 2021.

Laryngectomy

Your larynx, also called the voice box, helps you to breathe, eat and speak. A laryngectomy is a surgical procedure that removes all or part of the larynx. This is done most frequently to remove cancer that affects the larynx.

There are several types of laryngectomies, including:

  • Partial laryngectomy removes part of the larynx and is used for smaller tumors.
  • Supraglottic laryngectomy removes some of the larynx located above the vocal cords. You may still maintain your normal speaking voice after a supraglottic laryngectomy.
  • Hemilaryngectomy involves the removal of one vocal cord while maintaining the others. You are able to speak after a hemilaryngectomy, but it’s more limited.
  • Total laryngectomy takes out the larynx completely. It affects your ability to speak normally, although it’s possible to learn to speak in other ways, such as with a mechanical voice or esophageal speech training.

Your doctor chooses which laryngectomy to perform, depending on the location of the cancer and the cancer stage.

How it’s done

A laryngectomy requires anesthesia and takes about five to nine hours to perform.

First, the surgeon makes a cut in the neck to access the area where surgery is needed. Next, the surgeon removes the larynx (or part of the larynx, depending on the type of laryngectomy) and surrounding tissues. Lymph nodes, bean-shaped structures that are part of the immune system, also may be removed and analyzed for cancer cells.

Additionally, the surgeon may have to remove the pharynx, which is located between the nasal passages and esophagus.

Next, the surgeon performs a tracheostomy. This involves the creation of a hole in the front of the neck and into the trachea. This hole, called a stoma, allows the patient to breathe after surgery. A tube is inserted to keep the hole open. With a total laryngectomy, the stoma is permanent. The surgeon closes the area with clips or stitches.

Five ways to prepare for a laryngectomy

  1. Quit smoking. Smoking may reduce any benefits from treatment and increase the chance of other cancers occurring. If you have trouble quitting, ask your doctor for counseling and other aids to help.
  2. Expect to complete blood work, laboratory tests and imaging studies before your surgery.
  3. Meet with a speech therapist and a swallowing therapist. These professionals may explain what to expect after surgery in terms of speaking and swallowing.
  4. Let your doctor know about medications or over-the-counter herbs, vitamins or supplements you use—and ask whether you need to stop taking any before or the day of the procedure.
  5. Be prepared to not eat or drink anything after midnight prior to surgery day. If you’re able to take any medications, do so with a small sip of water.
 

Risks from a laryngectomy

Patients should consider that there are risks associated with any type of surgery and risks that are specific to a laryngectomy.

General risks related to any type of surgery include:

  • Blood clots
  • Breathing problems
  • Heart problems
  • Infection

Risks related to a laryngectomy include:

  • Decreased thyroid gland function
  • Esophagus or trachea damage
  • Fistulas (abnormal connections between the pharynx and the skin)
  • Mobility limitations in the neck and shoulder area
  • Problems with the stoma opening
  • Trouble eating, speaking or swallowing

Results from a laryngectomy

It takes two to three weeks and sometimes longer to heal from a laryngectomy. This includes spending additional time in the hospital after surgery.

Initially, you receive nutrition through a tube that goes from your nose to the esophagus. Within a few days to a week after surgery, the doctor may permit you to eat again through your mouth.

A laryngectomy is usually successful at removing cancer, but you may require other treatments, including chemotherapy and radiation. Expect to also return for regular follow-up care to make sure there’s not a recurrence.

Follow any instructions given by your care team to help you heal. These may include resting but also moving your legs regularly to help with circulation, which may reduce your chances of a blood clot. You may be advised to avoid heavy lifting and strenuous activity for six weeks.

Your care team helps teach you how to take care of your stoma laryngectomy tube. You may also learn how to speak again with the help of a speech therapist.

After a laryngectomy, many patients have trouble with their sense of smell. A type of training called olfactory rehabilitation may help with this.

Adjusting to life after a laryngectomy takes some getting used to—and you may feel overwhelmed by the initial changes. Let your care team and loved ones know of any concerns so they may help you cope.

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