Our Summary

The research paper discusses the evolution and current state of laryngectomy, a surgical procedure to remove all or part of the larynx (voice box), often used for treating advanced laryngeal cancer or for individuals who cannot be treated with radiation therapy. This surgery has a significant impact on the patient’s ability to swallow and speak.

While the surgery itself has not changed much since it was first performed about 150 years ago, the methods used to help patients regain their voice and swallowing abilities after surgery have greatly improved. The paper reviews the history of these rehabilitation methods, the current best practices for preparing for and managing recovery from the surgery, the surgical techniques used today, and the potential future developments in this area.

FAQs

  1. What is the purpose of a total laryngectomy and in what situations is it considered the best treatment option?
  2. How does a total laryngectomy affect a person’s speech and swallowing abilities?
  3. What are some of the latest developments and future prospects in the field of functional laryngeal reconstruction?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laryngectomy is to work closely with a speech therapist or a laryngologist to learn new ways of communicating after surgery. They can help teach techniques for speaking with a voice prosthesis or using alternative methods of communication. It is important to be patient and persistent in practicing these new skills to improve communication abilities.

Suitable For

Patients who are typically recommended for laryngectomy are those with far-advanced local disease or radiotherapy failures not amenable to partial laryngeal procedures. Laryngectomy is considered the optimal therapy for these patients and is the only curative option in some cases. Laryngectomy is a life-altering operation with profound effects on swallowing and speech, so patients must be carefully evaluated and counseled before undergoing the procedure. Additionally, patients must be willing and able to undergo post-operative management and rehabilitation to regain function after surgery.

Timeline

Before laryngectomy:

  • Patient may experience symptoms such as hoarseness, difficulty swallowing, throat pain, or a persistent cough.
  • Patient undergoes diagnostic tests such as a laryngoscopy, CT scan, or biopsy to confirm the presence of laryngeal cancer.
  • Patient may receive radiation therapy or chemotherapy as a first line treatment option.
  • If non-surgical treatments are unsuccessful, patient may undergo a total laryngectomy.

After laryngectomy:

  • Patient undergoes surgery to remove the larynx, resulting in the loss of the ability to speak and swallow normally.
  • Patient may receive speech therapy to learn alternative methods of communication such as esophageal speech or the use of a tracheoesophageal prosthesis.
  • Patient may undergo swallowing therapy to learn how to eat and drink safely without a larynx.
  • Patient may experience changes in their social and emotional well-being as they adjust to life without a voice box.
  • Patient may require long-term follow-up care to monitor for potential complications such as speech or swallowing difficulties, stoma care, or cancer recurrence.

What to Ask Your Doctor

  1. What are the risks and potential complications of a laryngectomy surgery?
  2. What is the expected recovery time and rehabilitation process after a laryngectomy?
  3. How will a laryngectomy affect my ability to speak and communicate?
  4. What options are available for voice and speech rehabilitation after a laryngectomy?
  5. How will a laryngectomy impact my ability to swallow and eat?
  6. What support resources are available for patients undergoing a laryngectomy?
  7. What follow-up care will be needed after a laryngectomy surgery?
  8. Are there any lifestyle changes or modifications that need to be made after a laryngectomy?
  9. What are the long-term effects of a laryngectomy on overall health and quality of life?
  10. Are there any alternative treatment options to consider before undergoing a laryngectomy?

Reference

Authors: Zenga J, Goldsmith T, Bunting G, Deschler DG. Journal: Oral Oncol. 2018 Nov;86:38-47. doi: 10.1016/j.oraloncology.2018.08.023. Epub 2018 Sep 12. PMID: 30409318