Our Summary

This research paper is a historical look at the contributions of a German surgeon named Themistocles Gluck to the development of a surgical procedure called total laryngectomy, which involves the removal of the larynx or voice box. This technique also includes the primary closure of the pharyngeal orifice, which is the opening that connects the nose and mouth to the esophagus and larynx. This procedure was proposed a few years after Theodor Billroth performed the first total laryngectomy in 1873. The paper emphasizes Gluck’s significant role in the evolution of this surgical procedure.

FAQs

  1. Who was Themistocles Gluck and what was his contribution to the field of laryngectomy?
  2. What is the significance of the technique of total laryngectomy with primary closure of the pharyngeal orifice?
  3. Who was Theodor Billroth and what was his role in the development of laryngectomy?

Doctor’s Tip

A doctor might tell a patient who has undergone a laryngectomy to practice good stoma care, including keeping the area clean and dry, using a stoma cover or bib to protect it from debris, and regularly changing the cover to prevent infection. They might also advise the patient to avoid smoking and exposure to secondhand smoke, as well as to stay hydrated and practice good oral hygiene to reduce the risk of complications.

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. Other reasons for recommending laryngectomy may include severe damage to the larynx due to trauma or severe infection, or in cases where there is a significant risk of aspiration of food or fluids into the lungs.

Timeline

Before laryngectomy:

  1. Patient is diagnosed with a laryngeal cancer or other condition that requires removal of the larynx.
  2. Patient undergoes various tests and consultations with medical professionals to determine the best course of treatment.
  3. Patient may undergo radiation therapy or chemotherapy to shrink the tumor before surgery.
  4. Patient receives counseling and education on the potential changes in speech and swallowing post-surgery.

After laryngectomy:

  1. Patient undergoes the surgical procedure to remove the larynx, typically under general anesthesia.
  2. Patient wakes up with a tracheostomy tube in place to help with breathing.
  3. Patient may experience temporary difficulty speaking and swallowing, as well as changes in taste and smell.
  4. Patient undergoes speech therapy and rehabilitation to learn how to communicate using alternative methods such as esophageal speech or a speech prosthesis.
  5. Patient may undergo further reconstructive surgery to create a tracheostoma for breathing and to improve cosmetic appearance.
  6. Patient continues to receive follow-up care and support from a multidisciplinary team of healthcare professionals to manage any complications and adjust to life after laryngectomy.

What to Ask Your Doctor

  1. What is a laryngectomy and why is it recommended for me?
  2. What are the risks and potential complications of a laryngectomy?
  3. How will a laryngectomy affect my ability to speak and swallow?
  4. What will my recovery process look like after a laryngectomy?
  5. Are there any alternative treatments or procedures that I should consider?
  6. How will a laryngectomy impact my quality of life in the long term?
  7. What type of follow-up care will I need after a laryngectomy?
  8. Are there any support groups or resources available for laryngectomy patients?
  9. What is the success rate of laryngectomy surgeries, and what can I expect in terms of outcomes?
  10. Can you explain the specific technique of total laryngectomy with primary closure of the pharyngeal orifice that will be used in my case?

Reference

Authors: Mudry A, Fakhry N. Journal: Eur Ann Otorhinolaryngol Head Neck Dis. 2023 Aug;140(4):187-189. doi: 10.1016/j.anorl.2022.11.001. Epub 2022 Dec 7. PMID: 36496346