What is laryngectomy?
Surgical removal of the larynx is called Laryngectomy. The larynx is the part of the throat that contains the vocal cords, which allows it to produce sound. The larynx connects the nose and mouth to the lungs. Protect your respiratory system by keeping the things you eat or drink in your esophagus and away from your lungs. If you have a larynx, it can affect your speech, swallowing, and breathing. You must learn new ways to do all three tasks after surgery.
Symptoms of laryngeal cancer
Some of the following may be symptoms of laryngeal cancer or they may be symptoms of other conditions:
- No sore throat or cough
- A change in your throat that does not improve after two weeks
- Any pain or other discomfort when swallowing
- A lump in the neck or throat
- Dysphonia (trouble producing voice sounds)
If you have any of the following symptoms, see your doctor immediately:
- Dyspnea (shortness of breath)
- Stridor (loud, noisy breathing)
- Balloon sensation (sensation of something in the throat)
- Hemoptysis (coughing up blood)
Laryngeal cancer diagnosis
These tests and procedures can be helpful in diagnosing laryngeal cancer:
- Physical exam: A doctor examines the throat and neck.
- Laryngoscopy: The doctor examines the larynx with a mirror or a flexible endoscope with a thin, lighted tube.
- Biopsy: The doctor removes a small part of the larynx to examine it under a microscope.
- Computed tomography or CT scan (also known as computed tomography, computed tomography, or computerized axial tomography): CT scan uses x-rays and computers to create images of the cross-section of the body.
- MRI (also known as magnetic resonance imaging): MRI uses a large magnet, radio waves, and a computer to create clear images or pictures of the human body.
- Positron emission tomography scan: A very small dose of a radioactive chemical called a radiotracer is injected into a vein in the hand. The marker travels through the body and is absorbed by the organs and tissues studied. A machine called a pet scanner creates three-dimensional images from a given force of tracer material.
There are three methods of treating cancer:
Most treatments use two or more of these methods. If prevention is not possible, the goal may be to prevent the tumor from growing or spreading for as long as possible (palliative care). Relief therapy can also help relieve symptoms. Cancer management can help doctors determine the best treatments for diagnosis and activity. The stages of cancer are determined by the size and exact location of the tumor.
Radiation therapy (radiation therapy)
People with early-stage laryngeal cancer can only be cured with radiation therapy. This treatment protects the voice. Radiation alone (without surgery) is successful in treating 80 to 90 per cent of people with stage I laryngeal cancer and 70 to 80 per cent with stage II cancer. Stages III and IV generally require a combination of radiation and chemotherapy.
Radiation therapy can also be given as adjuvant therapy (adjuvant therapy). Adjuvant therapy is used after surgery:
- Some cancer cells may still be present in the body.
- If the tumor is difficult to remove completely
- When the tumor penetrates the laryngeal wall.
- If the pathologist finds cancer cells in the lymph nodes
If the tumor is pressed against the windpipe, it can cause pain and make it difficult to breathe or swallow. Radiation therapy relieves symptoms by shrinking the tumor. Only a short course of treatment is needed to control symptoms (contamination). If radiation therapy does not destroy all the cancers, surgery may be needed to remove remaining cancer (called salvage surgery).
Chemotherapy alone does not cure this type of cancer. This is indicated for a variety of reasons:
- Combined with radiation therapy as an alternative to surgery (called chemotherapy)
- To reduce the risk of cancer recurrence after surgery.
- Slowing tumor growth and managing symptoms when cancer is incurable (palliative treatment)
Endoscopic laser surgery on the larynx is very effective. In stages I and II, surgery has better or equivalent prevention rates compared to radiation therapy.
Endoscopic dissection eliminates early laryngeal cancers. General anaesthesia is used. The surgeon inserts an endoscope (a camera with a camera and a light inside the tube) down the throat to detect cancer. Next, the surgeon uses a scalpel or laser to remove the cancerous tissue. A thin, hot beam of laser light. It reduces tissue and at the same time controls bleeding.
Surgery is often the best and only option for large cancers or cancers that do not respond to radiation treatments.
Types of laryngectomy procedures
There are three types of Laryngectomy procedures.
- Partial laryngectomy
- Supraglottic laryngectomy
- Total laryngectomy
The partial larynx is used to treat cancer of the minor larynx or cancer that has come back after radiation (recurrent cancer). During partial laryngitis, only part of the larynx is removed. You cannot remove at least part of a vocal cord. Patients may still be able to speak after a partial larynx, but the voice can be loud or weak. There are different types of partial larynx. Your doctor may use these names:
- Cardectomy is the removal of a vocal cord.
- Frontolateral laryngectomy is the removal of the anterior part of the vocal cords and most of the cancerous cord.
- Anterior frontal laryngectomy is the removal of the anterior part of two vocal cords.
- Removal of one side of the larynx is called a Hemi laryngectomy.
During the procedure, the surgeon makes an opening in the neck into the windpipe. This creates a temporary tracheostomy (hole in the neck for breathing). The tracheostomy allows the larynx to heal after surgery. After healing, patients generally speak and eat differently.
Supraglottic laryngectomy is used when the tumor is only in the area above the vocal cords. The surgeon uses a laser or an open technique to remove the structures of the larynx (false vocal cords and epiglottis) above the vocal cords.
During the procedure, the surgeon makes an opening in the neck into the windpipe. This creates a temporary tracheostomy (hole in the neck for breathing). The tracheostomy allows the larynx to heal after surgery. After healing, patients often speak and eat effectively.
The surgeon has to remove the entire larynx to cure cancer. This is called a total laryngectomy. The larynx connects the mouth to the lungs. After removal of the larynx, the air has nothing to do with entering the lungs. During the procedure, the surgeon makes an opening in the neck for breathing. The opening is called a tracheostomy or stoma. The stoma is permanent after the entire larynx.
Without vocal cords, patients cannot speak normally. One method that helps patients speak is by creating a fistula (a small opening in the tissue for air to escape). A fistula forms during laryngectomy.
Physical recovery after larynx
- Most laryngeal patients spend the first two days after surgery in the Intensive Care Unit (ICU). Your doctor will closely monitor your blood pressure, heart rate, breathing, and other important signs. You get oxygen through your stoma after surgery.
- You cannot eat by mouth while your throat is healing. A feeding tube that goes from your nose to your stomach or inserted directly into your stomach provides nutrition. Your neck may be swollen and sore. Get the pain relievers you need.
- When your condition stabilizes, you will go to the general hospital room. You are expected to stay in the hospital for about 10 days after surgery. During this time, you will continue to recover, learn to swallow again, and begin to learn to communicate without your larynx.
- Your doctor and nurses will encourage you to prevent blood clots, reduce the risk of pneumonia, and get used to your stoma and new airways. Getting out of bed is very important to recovery. You can receive speech and language therapy along with physical therapy.