Laryngeal Surgery- An overview

 

Laryngeal surgery is generally recommended for laryngeal cancer (Cancers that develop in the voicebox, or larynx), which affects the aerodigestive tract. This tract includes the upper digestive and respiratory organs, such as the mouth, vocal cords, nose, throat and windpipe.

Aerodigestive-related conditions usually appear as a sore throat, or difficulty speaking, swallowing, or breathing. Some aerodigestive illnesses can be treated with medicine, while others require surgery.

 

Diagnosis

 

Your doctor will have you get a few tests to figure out the stage of your cancer what treatment should be used. For laryngeal cancers, these tests may include:

• Physical test and imaging: Radiology tests can look inside your body to look at the cancer and determine if it has spread. These tests can include X-ray, CT scan, MRI and PET scan.


• Laryngoscopy: Uses a thin, lighted tube with a camera to look at the larynx (voice box) for any abnormalities. A biopsy may be done if needed.


• Endoscopy: An endoscope, or a lighted tube, is used to look for any abnormal areas. If needed, the endoscope can obtain tissue for a biopsy.

 

How is the performed?

 

Surgery for cancer of the larynx can be a big operation and is done under general anaesthetic so you will be asleep for the whole operation.

Usually surgery for early stage cancer is through your mouth (endoscopic surgery).  The position of your cancer affects how much of the voice box your surgeon removes.

• Removing part of the voice box (partial laryngectomy)- You might have a partial laryngectomy for early laryngeal cancer, or cancer that has come back after treatment (recurrent cancer).


• Removing the voice box (total laryngectomy)- Your surgeon might take out the whole of your voice box (larynx) to remove your cancer. This is called a total laryngectomy. They might also remove part of the pharynx.

Without your vocal cords and with a stoma, you are not able to speak in the normal way. This can be very difficult to cope with. But there are now several ways to help you make sounds and learn to speak again.  A speech therapist visits you before your operation to discuss the different ways of communicating after surgery.

 

Risks and side effects of the surgery

 

All surgery carries some risks, including blood clots, infections, complications from anesthesia, and pneumonia. These risks are generally low but are higher with more complicated operations.

• Surgeries that affect the throat or voice box can lead to a gradual narrowing (stenosis) of the throat or larynx (if it remains after surgery). Sometimes this can affect breathing.


• Throat or larynx surgeries may also sometimes affect your ability to swallow. This can affect how you eat, and might be severe enough to require a permanent feeding tube.


• A very rare but serious complication of neck surgery is rupture of a carotid artery (the large artery on either side of the neck).

 

 

Recovery

 

Recovery from laryngeal cancer surgery will depend on the extent of the procedure you have had.

You will be told how to care for your surgical incisions, any drains you may have, and feeding tube (if needed).

You will be given any other instructions before leaving the hospital.

Your medical team will discuss with you the medications you will be taking, such as those for pain, blood clot, infection, and constipation prevention and/or other conditions.