Don't be afraid of laryngectomy, let's talk about it!

It's normal to feel a great deal of fear and shock when your doctor tells you that your "voice box" or larynx needs to be surgically removed. You may have many questions in your mind, such as "What will happen to my voice?" and "Will I never be able to speak again?" But don't worry. Even though this is a major operation, you can still live well and speak in new ways after the operation. Let's talk about this Laryngectomy surgery simply and clearly.

Simply put, what is Laryngectomy?

A laryngectomy is a surgical procedure that removes part or all of your larynx. Some people also call it your "voice box." Your larynx is located just above your trachea. It's where your mouth, nose, and lungs connect. The larynx is essential for breathing, swallowing, and speaking.

Now you may be wondering, "Why remove this?" Your doctor will only recommend this type of surgery if your larynx has been severely damaged or has a medical condition.

There are two main reasons:

• Laryngeal cancer: This surgery is most often performed in cases of cancer of the larynx.
• Irreversible damage: Due to serious, irreversible damage to the larynx caused by a severe accident or other cause.

Sometimes only part of the larynx is removed. We call that a partial laryngectomy. Other times, the entire larynx has to be removed. We call that a total laryngectomy.

But there is good news. These surgeries are less common now than they used to be. This is because many people have stopped smoking and new methods have been developed to treat cancer without removing the larynx.

What should we do before the surgery?

Before surgery, your doctor will examine you thoroughly and may also order several other tests.

• Chest X-ray: Check the condition of your lungs.
• ECG test: See how the heart rate is.
• Blood tests: Check the general health of the body.

In addition, you will need to see several specialists. For example, a speech-language pathologist (SLP) and a swallowing therapist. They will help you adjust to life after surgery and learn to speak again. It is very important to make these appointments well in advance of your surgery.

If you smoke, your medical team will help you quit. You will also have the opportunity to talk to a dietitian to help you plan your diet after surgery.

Before the day of your surgery, your medical team will give you a clear set of instructions. They will often tell you to stop taking blood thinners a few days before the surgery. They will also tell you to stop eating and drinking the night before.

What happens during the surgery?

You will be under anesthesia throughout the surgery, which means you will not feel anything and will be asleep. The surgeon will follow these steps:

1. Making an incision: First, a small incision is made in the front of your neck.

2. Larynx removal: Your larynx (voice box) will then be removed. It may involve removing all or part of it, including the vocal cords. It may also involve removing nearby lymph nodes or parts of the throat tissue.

3. Creating a Stoma: This is the most important part. When your larynx is removed, you can't breathe through your nose like you used to. So, a small opening (hole) is created in your neck to create a new way to breathe . This is called a Stoma . A small tube is inserted into this stoma.

4. Voice Prosthesis (only if necessary): This is also done for some people. A small hole is made between the windpipe and esophagus, and a small device is inserted into it to help with speaking.

5. Closing the incision: Finally, the incision made on the neck is neatly closed with stitches.

What to expect after surgery?

After the surgery, you will need to stay in the hospital for about a week or two. For the first few days, you will be fed through a feeding tube . Once the medical team is sure that you can swallow safely, they will help you eat by mouth.

There are risks involved with any surgery. Some of the complications that can occur during this surgery are:

• Damage to surrounding organs such as the trachea or larynx.
• Fistulas, which are abnormal openings between the throat and the skin.
• Limited movement in the neck or shoulder.
• Decreased thyroid function.
• Problems associated with the stoma (e.g. infections, skin irritation) and difficulties in caring for it.
• Difficulty eating, swallowing, and speaking in the early stages.

Most people take about two to three weeks to fully recover from this surgery, but this can vary depending on your physical condition and the nature of the surgery.

How do you talk again after surgery?

This is the biggest problem for everyone. When your larynx and vocal cords are removed, you lose your voice. But that doesn't mean you can't speak again. You can definitely communicate again. You just have to learn new ways to do it. Your speech therapist (SLP) will be your biggest support on this journey.

Here are some key methods and tools to help you speak:

When do you need to talk to the doctor?

When you get home after surgery, pay attention to your condition. Call your doctor right away if you have any of these symptoms:

• Fever
• Pus draining from the suture site
• Other signs of infection (redness, swelling, severe pain)

However, if you experience chest pain or severe difficulty breathing , it is an emergency. Call 1990 (Suvaseriya) Ambulance Service immediately, or go to the nearest hospital Emergency Department (ETU) as soon as possible.

Having a laryngectomy is not easy. You may feel scared, angry, and even hopeless. Don't hold these feelings in. Talk to your doctor and family about it. They can help you. Also, seeking help from a counselor and joining a support group with people who have gone through the same thing as you can be a great help. The more you learn about this condition, the more confident and courageous you will be to face it.