Our Summary

This research paper reviews studies on laryngeal transplantation (LT), which is a surgical procedure to replace a damaged or diseased voice box. The researchers reviewed 626 abstracts and chose 25 articles for in-depth analysis. They looked at the details of the patients who received the transplants, the surgical techniques used, the drugs given to suppress the immune system and prevent rejection of the new larynx, and the outcomes of the transplants.

From the 25 articles, the researchers focused on four specific cases. Two of these patients had their voice box removed due to cancer, and the other two had suffered trauma to their larynx. Three of the four transplants were successful, with the patients able to speak and eat without the need for a tube. However, one patient died due to their cancer progressing, and another patient had to have the transplanted larynx removed 14 years after the procedure.

The research concludes that there is not enough data to definitively state where LT fits into the field of laryngology (the study of the larynx). While the results seem to suggest that the future of LT is uncertain, the researchers believe that ear, nose, and throat specialists should continue to explore and improve this procedure.

FAQs

  1. What is the main objective of the evaluation of laryngeal transplantation (LT)?
  2. What are the common reasons for laryngeal transplantation based on the study?
  3. What have been the outcomes of laryngeal transplantation based on the articles analyzed?

Doctor’s Tip

A helpful tip a doctor might tell a patient about laryngectomy is to ensure proper care of the stoma (surgical opening in the neck) to prevent infection and promote healing. This includes keeping the stoma clean and dry, changing the dressing regularly, and avoiding exposure to irritants or contaminants. Proper stoma care can help reduce the risk of complications and improve overall recovery after laryngectomy.

Suitable For

Patients who are typically recommended laryngectomy are those who have undergone total laryngectomy for laryngeal carcinoma or severe laryngeal trauma and have exhausted all other treatment options. These patients may have difficulty speaking or swallowing and may benefit from a laryngeal transplant to restore these functions. Additionally, patients who have a high risk of developing complications from laryngectomy, such as poor wound healing or recurrent infections, may also be recommended for laryngectomy.

Timeline

Before laryngectomy:

  1. Diagnosis of laryngeal cancer or severe laryngeal trauma.
  2. Consultation with a medical team to discuss treatment options.
  3. Pre-operative tests and evaluations to assess overall health and fitness for surgery.
  4. Education and counseling on the procedure and potential outcomes.
  5. Surgery to remove the larynx, typically followed by a temporary tracheostomy.

After laryngectomy:

  1. Recovery period in the hospital, which may include speech therapy and rehabilitation.
  2. Learning new methods of communication, such as esophageal speech, electrolarynx, or a tracheoesophageal puncture (TEP) voice prosthesis.
  3. Adjusting to changes in eating and swallowing, as the airway and food passage are now separated.
  4. Follow-up appointments with healthcare providers to monitor healing and address any complications.
  5. Long-term adjustments to lifestyle and self-care routines to manage the effects of laryngectomy on speech, breathing, and swallowing.

What to Ask Your Doctor

Some questions a patient should ask their doctor about laryngectomy may include:

  1. What are the potential risks and complications associated with laryngectomy surgery?
  2. How will the surgery affect my ability to speak and swallow?
  3. Will I need any additional procedures or treatments after the laryngectomy?
  4. What kind of rehabilitation and support services are available for laryngectomy patients?
  5. How will my quality of life be affected after the surgery?
  6. What are the long-term effects of laryngectomy on my overall health?
  7. Are there any alternative treatments or options to consider before undergoing laryngectomy?
  8. How often will I need to follow up with my doctor after the surgery?
  9. Are there any lifestyle changes or adjustments I should make after laryngectomy?
  10. What should I do in case of any complications or concerns after the surgery?

Reference

Authors: Céruse P, Vergez S, Marie JP, Baujat B, Jegoux F, Malard O, Albert S, Badet L, Blanc J, Deneuve S, Faure F, Fuchsmann C, Morelon E, Philouze P; ECLAT group. Journal: Eur Ann Otorhinolaryngol Head Neck Dis. 2024 Mar;141(2):81-85. doi: 10.1016/j.anorl.2023.12.001. Epub 2023 Dec 21. PMID: 38135563