Laryngectomy

What is a laryngectomy?

A laryngectomy is an operation to remove the larynx, or voice box.

Why is a laryngectomy performed?

A laryngectomy is most commonly performed to remove a cancer of the larynx. Either the whole larynx (total laryngectomy) or part of the larynx (partial laryngectomy) can be removed.

The surgery involves creating a new airway that opens in the lower neck for breathing. This new airway is permanent following a total laryngectomy, and temporary after a partial laryngectomy.

Because it seriously affects quality of life, a total laryngectomy is usually only recommended for advanced cancers that can’t be successfully treated without such radical surgery. If you need to have a laryngectomy, you’ll meet a team of health professionals who can help you deal with the surgery and manage your speaking, breathing and swallowing afterwards.

How to prepare for a laryngectomy

If you need to have a laryngectomy, your ear, nose and throat specialist or surgeon will discuss the laryngectomy procedure with you and arrange any necessary preliminary tests. You might also see a speech pathologist and psychologist or 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.

What happens during a laryngectomy

The surgeon will first create a new passage for breathing: a tube from the windpipe that opens out at the neck. This procedure is a tracheostomy (also known as a tracheotomy), and the breathing opening is a type of stoma.

The surgeon will then remove the larynx (or part of the larynx), and close the passage to ensure that food does not go down the windpipe.

A small opening will be made to allow air to travel from the oesophagus, or gullet, to the windpipe. With practice, many people who have had a laryngectomy can learn to speak using their oesophagus.

What to expect after a laryngectomy

Laryngectomy is a serious operation and will usually require several weeks in hospital for recovery. While your throat recovers, you’ll be fed through a tube into your stomach for a week or 2.

A laryngectomy is also a life-changing operation, affecting appearance, speaking, eating and other aspects of daily life. You will return home when you are ready and have learnt to manage your stoma (for example, when you can keep the airway open and humidified).

A speech pathologist can teach you how to talk using air from the oesophagus, or with communication aids such as an artificial larynx. Speech pathologists or specialised physiotherapists can also help you manage your airway and swallowing.

What can go wrong?

Laryngectomy is a complex procedure, and can sometimes result in:

• poor or no speaking ability
• difficulty swallowing
• food or drink falling into the windpipe
• infection
• saliva leaking out of the throat through the skin

A laryngectomy to remove a tumour does not guarantee that the tumour will not return, and your doctor will continue to monitor your long-term health.