Our Summary

This research paper looks at the outcomes of two types of surgeries used to treat advanced laryngeal cancer, which is cancer of the voice box. These surgeries, known as total pharyngolaryngectomy (TPL) and total laryngectomy (TL), are quite invasive and can result in significant health issues for the patient. The study looked at patients’ speech and swallowing abilities after these procedures, in particular following different types of pharyngeal resection (removal of part or all of the throat), using data collected over 20 years.

The findings from the analysis of 155 patients show that the extent of the pharyngeal resection and prior radiation therapy significantly affect the risk of surgical complications. Specifically, the more of the throat that is removed and the more radical the surgery, the worse the patient’s speech and swallowing abilities tend to be. This was particularly evident in patients who underwent surgery as a last resort after other treatments had failed.

FAQs

  1. What are the two types of surgeries used to treat advanced laryngeal cancer discussed in the research paper?
  2. How do total pharyngolaryngectomy (TPL) and total laryngectomy (TL) surgeries affect patients’ speech and swallowing abilities?
  3. How does prior radiation therapy and the extent of the pharyngeal resection affect the risk of surgical complications?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laryngectomy is to work closely with a speech therapist and a swallowing therapist to improve communication and swallowing function after surgery. These specialists can help with techniques and exercises to strengthen the muscles used for speech and swallowing, as well as provide strategies for coping with any changes in these functions. Regular follow-up appointments with these therapists can help monitor progress and address any issues that may arise.

Suitable For

Patients who are typically recommended for laryngectomy are those with advanced laryngeal cancer that has not responded to other treatments such as radiation therapy or chemotherapy. In particular, patients who have tumors that are too large or have spread too far for other treatments to be effective may be recommended for laryngectomy. Additionally, patients who have experienced recurrence of laryngeal cancer after initial treatment may also be candidates for laryngectomy.

Overall, laryngectomy is a last resort treatment option for patients with advanced laryngeal cancer who have exhausted other treatment options. The decision to recommend laryngectomy is made based on the individual patient’s specific case, including the size and location of the tumor, the patient’s overall health and ability to tolerate surgery, and the likelihood of the cancer responding to other treatments.

Timeline

Before laryngectomy:

  • Patient may experience symptoms of advanced laryngeal cancer such as hoarseness, difficulty swallowing, and a persistent cough.
  • Patient undergoes various diagnostic tests such as imaging studies and biopsies to confirm the diagnosis.
  • Patient may undergo chemotherapy and/or radiation therapy to shrink the tumor before surgery.
  • Patient meets with a multidisciplinary team including surgeons, oncologists, speech therapists, and nutritionists to discuss treatment options and prepare for surgery.
  • Patient undergoes laryngectomy surgery to remove the affected larynx and surrounding tissue.

After laryngectomy:

  • Patient wakes up from surgery with a tracheostomy tube in place to help with breathing.
  • Patient may experience temporary difficulty speaking and swallowing due to the surgery.
  • Patient receives speech therapy to learn how to communicate using alternative methods such as esophageal speech or a tracheoesophageal puncture (TEP) voice prosthesis.
  • Patient undergoes rehabilitation to improve swallowing function and adjust to changes in diet.
  • Patient may experience long-term side effects such as voice changes, swallowing difficulties, and changes in taste and smell.
  • Patient continues to follow up with their healthcare team for regular monitoring and support in managing side effects and adjusting to life after laryngectomy.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a laryngectomy surgery?

  2. How will my speech and swallowing abilities be affected after the surgery?

  3. Will I need additional therapy or rehabilitation to improve my speech and swallowing abilities post-surgery?

  4. How long will the recovery process be and what can I expect during this time?

  5. Are there any long-term effects or side effects I should be aware of after the surgery?

  6. Will I need any additional treatments or follow-up care after the surgery?

  7. How will my quality of life be impacted by the surgery?

  8. Are there any alternative treatment options available for my condition?

  9. How experienced is the surgical team in performing laryngectomy procedures?

  10. Can you provide me with any resources or support groups for patients who have undergone a laryngectomy surgery?

Reference

Authors: Layton T, Thomas R, Harris C, Holmes S, Fraser L, Silva P, Winter SC. Journal: Ann Otol Rhinol Laryngol. 2022 Dec;131(12):1301-1309. doi: 10.1177/00034894211072987. Epub 2022 Jan 26. PMID: 35081778