A laryngectomy is a surgical procedure in which all or part of the larynx is removed. Known as the voicebox, the larynx is a critical structure in the neck which routes air to the lungs and allows people to speak. Because the ramifications of this procedure are huge, it is only performed in situations when a surgeon thinks it is the only treatment option, and the surgeon will discuss the procedure in detail with the patient before performing it. The exception to this rule is in emergency treatment, where a surgeon may need to perform a laryngectomy to save a patient's life, in which case there may not be time for a detailed discussion of the procedure.
In this procedure, the patient is placed under general anesthesia and the surgeon enters through the neck, removing all or part of the larynx, depending on the patient's situation. When this operation is performed for cancer treatment, as is usually the case, the surgeon may remove the neighboring lymph nodes as well. Once the larynx is removed, the connection between the trachea and the nose and mouth is severed, which means that the patient's lungs cannot access air. To address this problem, the surgeon performs a tracheotomy, leaving the patient with a hole in the neck known as a stoma which allows the lungs to get air.
After a laryngectomy, the patient will not be able to speak. There are a number of ways to restore speech after a laryngectomy, including the use of an electrolarynx and physical therapy to teach the patient to use esophageal speech. Prosthetic devices can also be implanted during the surgery or later to help the patient speak. The patient will also need to adjust to the experience of breathing through a stoma, which can be unsettling at first.
In cases of cancer of the larynx, physicians usually prefer to try chemotherapy and radiation to attack the cancer first. If these measures do not work, laryngectomy surgery may be recommended to remove the cancerous tissue and prevent the cancer from spreading. This surgery may also be performed if a patient has experienced trauma to the larynx.
Before a laryngectomy is performed, patients should take the opportunity to talk with their surgeons. They may want to ask about the length of the healing time, how to care for the stoma, and how soon they will be able to start to learn to speak. If patients have concerns or fears, it is better to talk about them ahead of time than to go into the operating room feeling nervous. Patients may also want to ask if they can meet people who have undergone laryngectomy surgery to learn what to expect from someone who has actually experienced it.