Our Summary

This research paper presents a new surgical technique for inserting a voice prosthesis during a total removal of the larynx (the part of the throat containing the vocal cords). The process involves a small opening at the back of the throat, which allows for the backwards placement of the voice prosthesis, without needing to use a rigid scope in the food pipe. This method takes advantage of the potential of the stapler tool, which is used in combination with the first-time puncture of the windpipe and food pipe and placement of the voice prosthesis. From the researchers’ experience, this combined procedure does not lead to any negative side effects such as abnormal holes, excessive tension, or functional complications. Thus, this technique can be considered a good option that makes it easier to insert a voice prosthesis, even in cases of mechanical stitches.

FAQs

  1. What is the new surgical technique for hybrid primary tracheoesophageal puncture in stapler-assisted total laryngectomy?
  2. How does this new procedure eliminate the need for rigid esophagoscopy in voice prosthesis placement?
  3. Are there any potential adverse events associated with this new hybrid procedure in stapler-assisted total laryngectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laryngectomy is to practice deep breathing exercises and vocal exercises to help strengthen the muscles in the throat and improve speech after surgery. It is also important to stay hydrated and avoid smoking to promote healing and reduce the risk of complications. Additionally, regular follow-up appointments with a speech therapist and doctor are essential to monitor progress and address any concerns.

Suitable For

Patients who are typically recommended for laryngectomy are those with advanced stage laryngeal cancer that has not responded to other treatments such as radiation or chemotherapy. Other reasons for laryngectomy may include severe laryngeal trauma, severe laryngeal stenosis, or other conditions that affect the function of the larynx.

Timeline

Before laryngectomy:

  • Patient may experience symptoms such as hoarseness, difficulty swallowing, or a persistent cough
  • Patient undergoes diagnostic tests such as imaging studies or biopsies to confirm the presence of laryngeal cancer
  • Patient may undergo chemotherapy or radiation therapy to shrink the tumor before surgery
  • Patient meets with a multidisciplinary team including surgeons, oncologists, and speech therapists to discuss treatment options
  • Patient undergoes pre-operative counseling and education about the laryngectomy procedure and post-operative care

After laryngectomy:

  • Patient undergoes surgery to remove the larynx and create a stoma for breathing
  • Patient may stay in the hospital for several days to recover and receive post-operative care
  • Patient receives speech therapy to learn how to communicate using alternative methods such as esophageal speech or a voice prosthesis
  • Patient may need to adjust to changes in their appearance and learn how to care for their stoma
  • Patient may require ongoing medical follow-up and support to manage any complications or side effects of the surgery.

What to Ask Your Doctor

  1. What is a laryngectomy and why is it necessary in my case?

  2. What are the potential risks and complications associated with a laryngectomy procedure?

  3. How will a laryngectomy affect my ability to speak and swallow?

  4. What is a tracheoesophageal puncture and how is it performed during a laryngectomy?

  5. What are the benefits of using a voice prosthesis after a laryngectomy?

  6. How long will it take for me to adjust to using a voice prosthesis?

  7. Are there any specific lifestyle changes or dietary restrictions I should follow after a laryngectomy?

  8. How often will I need to see my doctor for follow-up appointments after the surgery?

  9. Are there any support groups or resources available for individuals who have undergone a laryngectomy?

  10. What are the chances of the cancer returning after a laryngectomy and what steps can I take to prevent this?

Reference

Authors: Galli J, Perna L, Rossi G, Corina L, Parrilla C. Journal: Head Neck. 2024 Feb;46(2):435-438. doi: 10.1002/hed.27571. Epub 2023 Nov 21. PMID: 37989711