Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.
Also talk to your doctor about ways to restore speech, such as:
- Tracheoesophageal puncture
- Hand-held speech aids
Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.

Anesthesia

General anesthesia will be used. You will be asleep during the procedure.

Description of the Procedure TOP

A cut will be made in the skin on your neck. The muscles that are attached to the larynx will be divided. The larynx and surrounding tissue will then be removed. Sometimes, a partial laryngectomy will be done. In this case, the doctor will remove the tumor and only part of the larynx. If you have this type of surgery, you may retain some normal speech and more of your normal swallowing function.

An opening called a stoma will be created through the skin in the neck. Next, the trachea will be connected to the opening. This will enable you to breathe through the hole. In some cases, a tracheostomy tube will be inserted. This tube, which fits into the stoma, will act as an airway, helping you to breathe. Drainage tubes will be inserted to drain blood and fluid. Lastly, the muscles and skin will be brought together and closed with stitches or clips.

How Long Will It Take? TOP

5-9 hours

How Much Will It Hurt? TOP

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay TOP

This surgery is done in a hospital. The usual length of stay is 7-14 days. Your doctor may choose to keep you longer if complications arise.

Post-procedure Care TOP

At the Hospital

While you are recovering at the hospital, you will:

Have an oxygen mask over the stoma.
Be given nutrition through an IV or a feeding tube. A speech pathologist or doctor will assess your ability to swallow. Depending on the results, you will progress to soft foods.
You may need to wear boots or special socks to help prevent blood clot formation in your legs
Learn how to:
- Use a call bell and message board to communicate.
- Keep the head of your bed raised.
- Move your legs while in bed to increase circulation.
Learn to care for your stoma and tracheostomy tube, which includes:
- Using a mist hood over the stoma
- Keeping water out of the stoma
- Covering the stoma with a shower hood when showering
- Suctioning secretions
Have the drains removed in about 5 days. The stitches will be removed in about one week.

At Home

When you return home, do the following to help ensure a smooth recovery:

Avoid lifting heavy objects and doing strenuous activity for up to 6 weeks.
Participate in a speech rehabilitation program. You will need to learn how to speak again. The program may involve speaking by:
- Swallowing air and expelling it—esophageal speech
- Using an electronic device—artificial larynx
- Installing a valve in the stoma to allow air from the lungs to reach the esophagus—tracheoesophageal speech

The throat tissue will heal in about 2-3 weeks. Complete recovery will take at least a month. You may notice a reduction in your sense of taste and smell. You will continue to use the stoma for breathing.

Most people are able to return to their jobs and past activities, except for swimming.

You may be referred to a support group to help you to cope with the surgery.

Call Your Doctor TOP

It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
Persistent nausea and/or vomiting
Pain that you cannot control with the medications you've been given
Cough, shortness of breath, or chest pain
Difficulty swallowing
Difficulty eating
Headache, muscle aches, or lightheadedness
Tracheostoma is getting smaller
Saliva is leaking through your incision
New, unexplained symptoms

If you think you have an emergency, call for medical help right away.

RESOURCES:

American Cancer Society
http://www.cancer.org

National Cancer Institute
http://www.cancer.gov

CANADIAN RESOURCES:

BC Cancer Agency
http://www.bccancer.bc.ca

Canadian Cancer Society
http://www.cancer.ca

References:

Hanasono MM, Lin D, Wax MK, Rosenthal EL. Closure of laryngectomy defects in the age of chemoradiation therapy. Head Neck. 2012;34(4):580-588.

Laryngeal and hypopharyngeal cancers. American Cancer Society website. Available at:
...(Click grey area to select URL)
Accessed May 9, 2016.

Laryngectomy. UC Davis Health System website. Available at:
...(Click grey area to select URL)
Accessed May 9, 2016.

Last reviewed June 2016 by Michael Woods, MD
Last Updated: 05/23/2014

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