Our Summary

This research paper is about a study conducted to understand if people who have had their entire larynx (voice box) removed, a procedure known as total laryngectomy (TL), experience significant sinus and nasal cavity disease. When the larynx is removed, it stops any airflow through the nose, causing changes in the nasal lining and how mucus is cleared from the nasal cavity.

To figure this out, the researchers looked at the medical records of 50 patients who had imaging scans done before and after their larynx removal surgery. They used a scoring system called Lund-Mackay to assess the scans and a questionnaire called SNOT-22 to understand the patients’ symptoms.

The findings suggested that the severity of sinus and nasal cavity disease before the larynx removal surgery was a key factor in determining whether the patients would have significant sinus and nasal cavity disease after the surgery. Only two patients needed further surgery for persistent sinus and nasal cavity disease after their larynx removal.

The paper concluded that the extent of sinus and nasal cavity disease before surgery is important in understanding whether a patient is likely to have significant sinus and nasal cavity disease after larynx removal. However, the study also recognized that more research is needed in this area to better identify suitable patients for the surgery.

FAQs

  1. What is the connection between total laryngectomy and sinus and nasal cavity disease?
  2. How did the researchers determine the severity of sinus and nasal cavity disease in patients who underwent total laryngectomy?
  3. Did the study find that larynx removal led to significant sinus and nasal cavity disease in most patients?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laryngectomy is to maintain good nasal hygiene to prevent sinus and nasal cavity disease. This can include using saline nasal sprays, keeping the nasal passages moist, and avoiding irritants such as smoke or strong odors. It is also important to follow up with regular appointments with an ear, nose, and throat specialist to monitor for any potential issues.

Suitable For

Patients who are typically recommended for laryngectomy are those who have been diagnosed with advanced-stage laryngeal cancer that cannot be treated with other methods such as radiation therapy or chemotherapy. Laryngectomy may also be recommended for patients with severe vocal cord dysfunction or other conditions that significantly affect their ability to breathe, speak, or swallow.

In addition, patients who have failed other treatments for laryngeal cancer or have recurrent cancer in the larynx may also be candidates for laryngectomy. Patients who have a history of smoking, heavy alcohol use, or exposure to certain chemicals that increase the risk of laryngeal cancer may also be recommended for laryngectomy.

Overall, the decision to recommend laryngectomy is based on the individual patient’s specific condition, overall health, and goals of treatment. It is important for patients to discuss their treatment options with their healthcare provider to determine the most appropriate course of action for their unique situation.

Timeline

Timeline:

Before Laryngectomy:

  1. Patient experiences symptoms of laryngeal cancer, such as hoarseness, difficulty swallowing, or a persistent cough.
  2. Patient undergoes diagnostic tests, such as imaging scans and biopsies, to confirm the presence of cancer in the larynx.
  3. Patient consults with an otolaryngologist (ear, nose, and throat specialist) to discuss treatment options, which may include total laryngectomy.
  4. Patient undergoes preoperative evaluations and counseling to prepare for the surgery, which may include imaging scans of the sinuses and nasal cavity.

After Laryngectomy:

  1. Patient undergoes total laryngectomy surgery to remove the entire larynx.
  2. Patient may experience temporary side effects such as difficulty speaking, swallowing, or breathing, which may require speech therapy and rehabilitation.
  3. Patient undergoes postoperative imaging scans to assess the sinuses and nasal cavity for any changes.
  4. Patient may experience symptoms of sinus and nasal cavity disease, such as nasal congestion, postnasal drip, or facial pain, due to changes in airflow and mucus clearance.
  5. Patient may require further treatment, such as medication or additional surgery, to manage any persistent sinus and nasal cavity disease.

Overall, the timeline for a patient before and after laryngectomy involves a series of evaluations, treatments, and potential complications related to both the primary cancer and the effects of larynx removal on the sinuses and nasal cavity. It is important for healthcare providers to closely monitor and manage these patients to ensure optimal outcomes and quality of life.

What to Ask Your Doctor

  1. What is the likelihood of developing sinus and nasal cavity disease after a total laryngectomy?
  2. Are there any specific risk factors that increase the chances of developing sinus and nasal cavity disease post-surgery?
  3. What symptoms should I watch out for that may indicate sinus and nasal cavity disease after a laryngectomy?
  4. How will sinus and nasal cavity disease impact my overall health and quality of life after a laryngectomy?
  5. Are there any preventative measures or treatments available to reduce the risk of developing sinus and nasal cavity disease post-surgery?
  6. How often should I have follow-up appointments to monitor for sinus and nasal cavity issues after a laryngectomy?
  7. Are there any lifestyle changes or medications I can take to help manage sinus and nasal cavity symptoms post-surgery?
  8. What are the potential long-term effects of sinus and nasal cavity disease if left untreated after a laryngectomy?
  9. Are there any specialists or additional tests I should consider seeing or undergoing to further evaluate sinus and nasal cavity health after a laryngectomy?
  10. How can I best communicate any concerns or symptoms related to sinus and nasal cavity disease with my healthcare team post-surgery?

Reference

Authors: Patel VA, Pool CD, Dunklebarger M, Schaefer E, Goyal N. Journal: Ann Otol Rhinol Laryngol. 2019 Sep;128(9):811-818. doi: 10.1177/0003489419839410. Epub 2019 Apr 23. PMID: 31014074