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Laryngectomy is a procedure to remove all or part of the voice box (larynx). The larynx is the part of your throat where your vocal cords are located. It allows you to produce sound. It also connects your mouth and nose to your lungs. In addition, the larynx protects your breathing system by keeping the things you swallow in the esophagus, out of the lungs.
Laryngectomy is a treatment option for people who have cancer of the larynx, develop radiation necrosis (damage to the larynx due to radiation treatment), or have sustained a severe injury to the neck.
Before the surgery starts, you will be given general anesthesia. Your surgeon begins the surgery by creating incisions in your neck. Your larynx will be removed through these incisions. Depending on the reason you undergo a laryngectomy, lymph nodes and some parts of your pharynx may also be removed.
Once the larynx is removed, your surgeon will create a stoma. A stoma is a permanent hole about the size of a nickel in the front of your trachea. You will continue to breathe through this hole as it links directly from the outside to your lungs.
In some cases, a procedure called tracheoesophageal puncture (TEP) may be performed during laryngectomy. This procedure is done to separate the trachea and esophagus to allow you to have a voice.
Once the procedure is complete, the incisions will be closed with stitches.
Expect to stay in the hospital for around 10 days following your surgery. It is advisable that you stay in Thailand for at least 14 days because you need to attend follow-up checkups. During your stay in the country, you will continue to heal and your doctor will monitor your condition constantly through the checkups.
You should be able to go back to work and your normal activities within 6 to 8 weeks after you are discharged from the hospital. However, you may need more time to recover if you underwent treatment for cancer, such as chemotherapy. Your doctor will give you a detailed recovery timeline, which includes when you can start exercising and perform strenuous activities.
Laryngectomy will affect your speaking, breathing, and swallowing. You will need to learn new ways to perform all three following your surgery.
For the first 2 to 3 weeks, you will need to get food through a tube that goes into your nose and down to your stomach or through a tube that goes directly into your stomach. Your doctor will teach you how to use a feeding tube. Your doctor will also teach you how to care for your stoma. Proper care of the stoma is essential to limit complications, such as infection. You generally need to be careful when showering and shaving if you have a stoma in your neck.
Since communicating after laryngectomy can be challenging, you will need speech rehabilitation. There are several different ways to communicate:
Nonverbal communication includes facial expressions, gestures, mouthing words without using your voice, and using picture boards. Writing or typing is also nonverbal communication.
Esophageal speech is a form of speech in which you use air from the mouth and trap it in your throat and upper esophagus. It is effective but can be difficult to learn.
TEP speech involves the use of the tracheoesophageal puncture (TEP). Through the TEP, a one-way valve is inserted. Often, the valve is attached to a voice prosthesis, helping you speak.
Electrolarynx is a device placed against your neck that can enhance your speech when you talk. It is very easy to learn and use, but the voice produced may sound robotic.
Losing your ability to talk can especially be very upsetting and hard to accept. It is recommended that you consult with a counselor.
Laryngectomy is a promising procedure. While the success rate depends largely on the underlying cause of your laryngectomy, it is generally effective and safe. However, like any surgical procedure, it carries some potential risks, such as infection and bleeding. The stoma can also be blocked, cutting off the air supply to the lungs.
It is important that you seek immediate medical care if you have pain that does not get better, have blood leaking from your incisions, or have signs of infection.
The alternative to laryngectomy depends on the reason you need the procedure. For those with laryngeal cancer, larynx preservation techniques using radiation therapy and chemotherapy may be suggested as alternatives. Make sure to talk to your doctor about the alternatives if you do not want to undergo laryngectomy.
Before laryngectomy, you may have a serious condition in your larynx that may be dangerous and causes painful symptoms, such as laryngeal cancer. After the surgery, the condition should be treated and any symptoms should be relieved. Speaking, breathing, and swallowing will be different after the surgery. Learning to live without a larynx can be scary, difficult, and frustrating. However, it can be done successfully. Numerous medical centers provide support groups to help you after your surgery.
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