When your doctor tells you that you need to have a laryngectomy, a surgery to remove your voice box, you may feel a great deal of fear and shock. You may have many questions in your mind, such as "How will I ever speak again?" and "What will happen to my life in the future?" This is very normal. But don't worry. Let's talk about everything simply and clearly.
Simply put, what is a laryngectomy?
Laryngectomy is a surgical procedure that removes all or part of your larynx (voice box).
Think of your larynx as a small device that works at three important junctions. It's located above your trachea (windpipe). It connects the airways that come from your nose and mouth to your lungs.
This larynx has three main functions:
- Helping you speak: The vocal cords that produce your voice are located here.
- Helping to breathe: The airways in the lungs are opened.
- Assisting with swallowing: When swallowing, it protects food from entering the trachea.
Why would someone want to have this surgery?
There are several reasons why a doctor may recommend this surgery. Depending on the severity of your condition, they may decide to remove only part of your larynx (Partial Laryngectomy) or the entire larynx (Total Laryngectomy).
See the table below for the main reasons.
| Reason for surgery | A simple explanation |
|---|---|
| Laryngeal cancer | This is the most common cause. The larynx has to be removed to remove the cancer cells. |
| Laryngeal fracture | A severe blow to the neck in an accident can fracture the bones of the larynx. |
| Severe damage | When the larynx is irreparably damaged by another accident or injury. |
| Damage caused by radiation therapy (Chondronecrosis) | This is a very rare condition. It can occur due to damage to the cartilage of the larynx after radiation therapy for cancer. |
What happens before the surgery?
Okay, let's say you've decided to have surgery. Before that, your doctor will examine you thoroughly. He will also run a few tests to see if your body is ready for the surgery.
- Blood tests: Usually, things like a complete blood count are done.
- Chest X-ray: Check the condition of your lungs.
- ECG test (Electrocardiogram): Check if your heart function is at a level that can withstand surgery.
In addition, your doctor will refer you to several other specialists, such as a Speech-Language Pathologist and a Swallowing Specialist . These people will help you prepare for life after surgery. So don't miss these appointments.
If you are a smoker, you will be given advice and support to quit before surgery. You will also be given nutritional advice to help you recover quickly after surgery.
How the surgery is performed
This surgery is performed under general anesthesia. So you won't feel any pain or anything. The surgeon will follow these steps:
1. Making an incision: First, the surgeon carefully makes an incision on the skin of your neck.
2. Larynx removal: Next, depending on your condition, part or all of your larynx will be removed. Sometimes, the lymph nodes or part of your throat (pharynx) may also need to be removed.
3. Creating a Stoma: This is the biggest change after surgery. The surgeon will create a small opening in the front of your neck, directly connected to your windpipe. This opening is called a stoma . After surgery, you will breathe through this stoma. A small tube (`laryngectomy tube`) is initially placed to help with this.
4. Making a TEP: In some cases, the surgeon makes a small hole between your windpipe (trachea) and your esophagus (oesophagus). This is called a `Tracheoesophageal Puncture (TEP).` This is done so that a device (`voice prosthesis`) can be inserted later to help you speak. However, this is not suitable for everyone. You should talk to your doctor and decide if this is right for you.
5. Closing the incision: Finally, the incision is closed with stitches.
After surgery, you will usually stay in the hospital for a week or two. During this time, the medical team will take good care of you. For the first few days, you will be fed through a feeding tube. The tube will be removed when you are able to swallow liquids.
How do you talk after surgery?
This is the thing that scares most people. Yes, surgery will take away your natural voice. But that doesn't mean you'll never be able to speak again. You can learn new ways to speak, and your speech therapist can help you with that.
Below are some of the main methods.
| Communication method | How it works |
|---|---|
| Voice Prosthesis | If a TEP hole was made during surgery, this small device is attached to it. After training, you will be able to direct air from your lungs into your throat and form words with that vibration. |
| Electrolarynx | This is a small battery-operated device. When you put it around your neck and press it, you can make words from the vibrations it produces. Although it sounds a bit robotic, it's a great way to start talking quickly. |
| Esophageal Speech | This method does not require any equipment. It involves taking air through the mouth, holding it in the throat and larynx, and then exhaling it in a controlled manner to form words. This requires a lot of practice. |
| Nonverbal Communication | During recovery, everyone needs to use these methods. This includes gestures, lip-smacking, facial expressions, handwriting, and typing on a phone or computer. |
What are the risks and complications of the surgery?
As with any surgery, laryngectomy surgery can have certain risks and complications.
Common risks
- Infection
- Blood clots
- Heart conditions
- Difficulty breathing
Surgery-specific complications
- Damage to the trachea or bronchi
- Decreased thyroid function
- Difficulty swallowing food, drinks, and speaking
- Restriction in neck and shoulder movement
- Abnormal connections (fistulas) between the throat and the skin
- Stoma-related problems
How long does it take to recover and what to look out for?
It usually takes two to three weeks to recover, but this time can vary from person to person, depending on your body's ability to heal and the extent of the surgery.
If you have had surgery for cancer, you may also need other treatments, such as radiation therapy or chemotherapy , to prevent the cancer from coming back. It is also important to see your doctor for follow-ups at the scheduled times.
Your medical team will teach you how to breathe, speak, swallow, and care for your stoma again. Following these instructions exactly is essential for a speedy recovery.
When to seek immediate medical advice
When you return home after surgery, you should immediately report any symptoms that arise.
| When to see a doctor | |
|---|---|
| Talk to your doctor: | |
| - If you have a fever | - If there is pus or redness around the incision |
| Go to the nearest Emergency Department (ETU) immediately: | |
| - If you have chest pain | - If you have severe difficulty breathing |
Don't fight the emotions you feel when you're told you have to have surgery like this alone. Talk to your doctor, family, or a trusted friend about your feelings and fears. If necessary, seek the help of a counselor. Also, joining support groups with people who have had similar experiences will be a great source of strength.
Take-Home Message
- Laryngectomy is a surgical procedure to remove the larynx, mainly for cancer.
- After the surgery, you will breathe through an opening called a stoma created in the front of your neck.
- Even if you lose your natural voice, you can learn new ways to speak with the help of a speech therapist.
- Your mental health is just as important as your physical health. Don't be afraid to talk about your feelings and get the support you need.
*There is a dedicated medical team to help you on your recovery journey. Follow their advice.
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න