Laryngectomy

A laryngectomy is an operation to remove all (total laryngectomy) or part of your larynx (partial laryngectomy).

The surgery involves creating a new airway that opens in your lower neck for breathing.

If you have a total laryngectomy, your new airway is permanent. If you have a partial laryngectomy, your new airway is temporary.

A total laryngectomy can seriously affect your quality of life. Therefore, it is usually only recommended for advanced cancers that cannot be successfully treated without such radical surgery.

You may need a laryngectomy to remove a cancer of the larynx.

It is commonly used for treatment of certain cancers when:

• it is unlikely radiation therapy will cure the cancer
• radiation has already been used
• the cancer has damaged the voice box or swallowing passage

If you need to have a laryngectomy, your ear, nose and throat (ENT) specialist or surgeon will discuss the laryngectomy procedure with you. They will arrange any tests you will need.

You might also see a speech pathologist, psychologist and/or a social worker to prepare you for recovery and managing both physically and emotionally after the surgery.

You should follow any guidelines your doctor or hospital gives you on how to prepare for admission to hospital. For example, you will be asked not to eat or drink some hours before the operation.

Read more about preparing for surgery.

During a laryngectomy, your surgeon will:

• cut the centre of your neck
• remove all or part of your larynx
• create your tracheostoma (a new opening for breathing) — your surgeon sews the top of your windpipe to the skin at the front of your neck
• create a hole at the back of your tracheostoma to your oesophagus that can be used for talking

After your laryngectomy, you will need to remain in hospital for a few weeks as you recover.

Parts of your recovery will include:

Eating

Initially you will be fed a special formula via a feeding tube going from your nose to your stomach. Slowly as you heal you will start eating and drinking by mouth.

A dietitian will support you throughout this process.

Your sense of smell and taste may be reduced because air is no longer travelling through your mouth and nose.

Speaking

You will not be able to speak in your usual way. After surgery you may need to communicate by writing things down. It could be useful to have a pen and paper, mini whiteboard or tablet.

A speech pathologist will help you with voice rehabilitation. Depending on your situation, you may learn to speak by:

• swallowing air and expelling it (oesophageal speech)
• using an artificial larynx with an electronic device (electrolarynx)
• using a speech valve in the hole of your stoma

Breathing

You may need to be connected to an oxygen mask or a special filter to humidify the air you breathe. This will keep your lungs comfortable. Overtime, your trachea will adapt. You will not need humidified air all the time.

The new airway opening created by your surgeon is called a stoma. It will be large enough for you to get all the air you need to breathe easily.

Stoma care and hygiene

Your nurses and speech pathologist will teach you to look after your stoma.

Good stoma care is very important to help maintain an open airway, prevent infection and promote healing.

This is a life changing surgery that affects many aspects of your life. You will only be discharged when you are ready and have learnt to manage your stoma.

You will continue to see your dietitian, speech pathologist, doctor and any other members of your healthcare team.

Laryngectomy is a complex procedure and can sometimes result in the following complications:

• bleeding at your stoma
• irritated skin around your stoma
• poor or no speaking ability
• blockage of your stoma
• infection
• saliva leaking out of the throat through the skin
• damage to nerves or parathyroid glands, which are located next to the larynx

• Cancer Council Australia has published 'Understanding surgery: a guide for people with cancer, their families and friends'.
• Visit Laryngectomee Association of Victoria (a laryngectomee is a person who has had a laryngectomy) for information and support.
• Head & Neck Cancer Australia has a laryngectomy guide explaining aspects of the procedure and recovery afterwards.

If you or someone you know is struggling with a new cancer diagnosis, Cancer Council has local and telephone support groups throughout Australia.