Laryngectomy
Laryngectomy is a surgical procedure that involves the removal of all or part of the larynx, commonly known as the voice box, primarily due to advanced laryngeal cancer that cannot be effectively treated with radiation therapy. The surgery is performed under general anesthesia and results in the creation of a permanent opening, or stoma, in the neck through which the patient breathes. This procedure can be indicated by persistent hoarseness, coughing, or the presence of polyps and warts on the larynx, which may need to be biopsied to rule out cancer. While laryngectomy significantly impacts a person's ability to speak, it is possible to learn alternative methods of communication through speech therapy, such as esophageal speech or the use of an electronic larynx. Patients must also adapt to new challenges, including changes in swimming and bathing practices due to the stoma. Despite these adjustments, many individuals can maintain a good quality of life post-surgery. Understanding these aspects can help individuals and families navigate the implications of laryngectomy with sensitivity and support.
Subject Terms
Laryngectomy
Anatomy or system affected: Respiratory system, throat
Definition: The removal of all or part of the voice box or larynx
Indications and Procedures
Continued hoarseness and coughing can indicate laryngeal disorders. Polyps, which may be caused by excessive smoking or drinking, can form on the larynx. Children sometimes develop warts on it. Although these polyps and warts are generally benign, they should be removed and subjected to biopsy to preclude the presence of cancer. Surgery to remove all or part of the larynx, sometimes called the voice box, is known as a laryngectomy.
Polyps, warts, and tumors are all detected quite easily with a laryngoscopic examination carried out by an otorhinolaryngologist with a mirror, an endoscope (a flexible fiber-optic tube), or a combination of the two. Such an examination, in addition to determining whether a growth is benign or cancerous, can detect signs of cancer in the lining of the larynx.
If laryngeal cancer is detected early enough, radiation therapy can usually control it. If the disease has advanced significantly, however, a laryngectomy may be necessary. In this surgical procedure, performed under general anesthesia, an incision is made in the neck, and the larynx is removed. The windpipe directly below the larynx is then sewn to the skin around the surgical opening to form a permanent opening, or stoma, through which the patient breathes.
Uses and Complications
A laryngectomy is performed when laryngeal cancer is sufficiently advanced that radiation therapy cannot destroy it. The major complication is that the patient’s air supply is now taken through the stoma, meaning that swimming is precluded and that bathing must be undertaken with considerable caution.
A more apparent complication is that, with the loss of the larynx, one cannot speak. Through an extensive and painstaking course of speech therapy, however, esophageal speech can be achieved. This involves swallowing air and expelling it in such a way that it can be shaped by the palate, lips, and tongue into understandable words and sentences. An electronic larynx is also available. It makes a buzzing sound that the patient can convert into words when the device is pressed against the top of the throat. As long as the patient adapts to new ways of speaking, swallowing, and breathing following a laryngectomy, a good quality of life can still be achieved.
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