Laryngectomy refers to the removal of the larynx and also the separation of the airways from the mouth, nose and esophagus. It is done either partially or totally, with the difference being in total laryngectomy the entire larynx is removed, while in partial one only a portion is taken out. This procedure is common in people suffering from laryngeal cancer. One noteworthy thing is that this procedure is performed only as a last resort, with doctors usually preferring other more conventional surgical procedures.
Preparation for Laryngectomy
Before undergoing this procedure, patients need undergo some preparation measures such as,
- Routine blood work
- Physical exam
- Smoking cessation
- Temporarily stopping medication use
- Fasting after midnight the night before undergoing surgery
What is a Laryngectomy ?
The surgical procedure is performed to remove the voice box (larynx) and the separation of the airway from the esophagus, nose and the mouth. A part or all of the larynx can be removed. Owing to its location, larynx (voice box) plays a crucial role in swallowing, speaking and breathing. The larynx is located in the front of the esophagus (food pipe) and above on the trachea (windpipe). Larynx consists of two small bands of muscle (vocal cords) that helps in preventing the food from entering into the lungs and it vibrates to generate the voice. Laryngectomy is performed to remove the cancerous or tumor tissues.
Throat Cancer Symptoms
- Location and size of the tumors are the two important factors for determining the symptoms-
- While coughing the blood comes out
- Constant cough
- A mass or lump either in the throat or in the neck
- Persistent or constant sore throat
- Difficulty in breathing
- The pain from the throat can result in ear pain
The surgical procedure is performed under general or local anesthesia. The surgeon in total laryngectomy will make cuts in the neck in order to open up the area. The crucial parts of the surgery
- The first step is the removal of lymph nodes
- The surgeon then removes the tissues and the larynx around it.
- An opening is made in the patient’s trachea along with a hole in front of the neck.
- The patient’s trachea is brought up and is then attached to stoma (hole)
- After the surgical procedure, the patient will breathe from the stoma and the stoma is never removed.
- Clips or stitches are used to thoroughly close the skin and the muscles.
- Tracheoesophageal puncture (TEP) is a little hole in the trachea (windpipe) and the tube which is responsible for sending food from the throat into the stomach (esophagus).
- Prosthesis (a little man-made part) will be placed into the opening. With the help of Prosthesis, the patient is able to speak after the removal of the voice box.
- Minimally Invasive Surgery for Laryngectomy
The less invasive surgeries works for specific people and largely depends upon the type of the cancer and also on how much the cancer has spread. Some of the procedures are vertical partial laryngectomy, supracricoid partial laryngectomy, supraglotticor horizontal partial laryngectomy and endoscopic surgery.
The procedure of removing a part of larynx instead of the whole is a very rare case. In this, a part of the voice box is left in order to be able to speak. But this results in the hoarse and weak voice. A temporary tracheotomy may be present that enables one to breathe.
Treatments for Laryngeal Cancer
Radiotherapy : It is the most common treatment and is used for treating early stage cancers. The therapy helps in shrinking a large tumor of the larynx that makes it easy to remove.
Chemotherapy : Both radiotherapy and chemotherapy can be performed simultaneously to treat the cancer. Chemotherapy is also used when the cancer of the larynx again occurred after radiotherapy. The advanced cancer can be treated before with the help of chemotherapy (induction therapy).
Biological Therapy : This type of treatment is made up of natural body substances. The patient may opt for biological therapy which is also called as cetuximab. In this, radiotherapy can also perform for locally advanced squamous cell laryngeal cancer.