Our Summary

This research paper explains a new surgical technique for treating laryngeal cancer (cancer of the voice box). The common method used is endoscopic laser surgery, which allows doctors to remove the tumor while minimizing side effects and improving recovery. During this surgery, part of the epiglottis (a flap of tissue at the base of the tongue that keeps food from going into the windpipe) is often removed, leaving an open wound that isn’t usually reconstructed.

However, the surgical technique described in this paper includes rebuilding the epiglottis after part of it has been taken out. The cut edge of the epiglottis is stitched to the base of the tongue, creating a new epiglottis and rebuilding a small area in the throat (the vallecula) that was once there. This not only makes the throat look more like it did before surgery, but it also helps improve swallowing after surgery.

FAQs

  1. What is the main advantage of endoscopic laser surgery for laryngeal cancer?
  2. What is the purpose of reconstructing the epiglottis after partial resection in endoscopic laser surgery?
  3. How does the endoscopic reconstruction of the epiglottis contribute to improving postoperative swallowing?

Doctor’s Tip

One helpful tip a doctor might tell a patient after a laryngectomy is to practice swallowing exercises regularly to help improve swallowing function post-surgery. This can help prevent complications such as aspiration and improve overall quality of life. Additionally, staying hydrated and eating smaller, more frequent meals can also aid in the swallowing process.

Suitable For

Patients who are typically recommended laryngectomy are those with laryngeal cancer that has not responded to other treatments such as radiation therapy or chemotherapy. Laryngectomy may also be recommended for patients with advanced stage laryngeal cancer that has spread to other parts of the body. Additionally, patients with recurrent laryngeal cancer or those who are unable to undergo other treatments due to various reasons may also be candidates for laryngectomy.

Timeline

Before laryngectomy:

  • Patient is diagnosed with laryngeal cancer and undergoes various tests and evaluations to determine the extent of the disease.
  • Patient may undergo radiation therapy or chemotherapy as part of their treatment plan.
  • Patient may experience symptoms such as hoarseness, difficulty swallowing, or a persistent cough.
  • Patient discusses surgical options with their healthcare team and decides to undergo laryngectomy.

After laryngectomy:

  • Patient undergoes the laryngectomy surgery, which involves removal of the larynx and possibly other nearby structures.
  • Patient may stay in the hospital for a period of time to recover from the surgery and receive postoperative care.
  • Patient may receive speech therapy to learn how to communicate using alternative methods such as a tracheoesophageal puncture (TEP) or an electrolarynx.
  • Patient may undergo rehabilitation to learn how to swallow safely and effectively without a larynx.
  • Patient may experience changes in their voice, breathing, and swallowing function, which may improve over time with therapy and practice.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a laryngectomy procedure?
  2. How will my ability to speak be affected after a laryngectomy? Are there speech rehabilitation options available?
  3. What kind of post-operative care and follow-up will be required after a laryngectomy?
  4. How will my ability to swallow be affected after a laryngectomy? Are there rehabilitation options available for swallowing difficulties?
  5. Will I need a tracheostomy tube after a laryngectomy, and if so, for how long?
  6. What lifestyle changes or adaptations will I need to make after a laryngectomy?
  7. Are there support groups or resources available for patients who have undergone a laryngectomy?
  8. How long is the typical recovery time after a laryngectomy procedure?
  9. Are there any dietary restrictions or modifications I will need to follow after a laryngectomy?
  10. What are the long-term effects and outcomes of a laryngectomy procedure?

Reference

Authors: Moulin M, Righini CA, Castellanos PF, Atallah I. Journal: Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Jun;135(3):197-199. doi: 10.1016/j.anorl.2017.12.003. Epub 2018 Jan 12. PMID: 29338941