Our Summary

This research paper is about a medical procedure called a laryngectomy, where the larynx (or voice box) is removed, usually to treat cancer. After this operation, a permanent hole, called a stoma, is made in the neck to allow the patient to breathe. However, more than 60% of people who have this procedure experience complications with their stoma.

The aim of this paper is to inform general doctors about these complications, so they can provide better care for patients with a stoma and improve their health outcomes.

Patients who have had a laryngectomy can have a variety of complications, some of which can be life-threatening and need to be identified quickly. Care for these patients involves a team of healthcare professionals, and general doctors are often the first point of contact.

Therefore, it’s very important that these doctors are well-informed. They need to be able to treat the patient and recognize when the patient needs to see a specialist nurse, a speech therapist, or a surgeon.

FAQs

  1. What is a laryngectomy stoma and why is it formed?
  2. What are the potential complications of a laryngectomy stoma?
  3. What is the role of a general practitioner in the care of a patient who has had a laryngectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laryngectomy is to regularly clean and care for the stoma site to prevent infections and other complications. This may include using gentle soap and water to clean the area, keeping the stoma dry, and regularly changing any dressings or tracheostomy tubes. It is also important for the patient to follow any specific care instructions provided by their healthcare team and to seek medical attention if they notice any signs of infection or other issues with the stoma site.

Suitable For

Patients who undergo laryngectomy are typically those with advanced laryngeal cancer that has failed to respond to other treatments such as radiation therapy or chemotherapy. Other conditions that may warrant a laryngectomy include severe trauma to the larynx, recurrent aspiration pneumonia, or severe laryngeal stenosis. Additionally, patients with certain benign laryngeal conditions such as severe laryngeal papillomatosis or laryngeal tuberculosis may also require a laryngectomy. Ultimately, the decision to recommend a laryngectomy is made on a case-by-case basis by a multidisciplinary team of healthcare professionals.

Timeline

Before laryngectomy:

  • Patient is diagnosed with a condition requiring removal of the larynx, such as cancer
  • Patient undergoes pre-operative consultations, tests, and preparations for surgery
  • Patient may undergo radiation or chemotherapy treatment prior to surgery
  • Patient undergoes total laryngectomy surgery, where the larynx is removed and a stoma is created in the neck for breathing

After laryngectomy:

  • Patient wakes up with a tracheostomy tube in place to help with breathing
  • Patient stays in the hospital for monitoring and recovery
  • Patient receives education on stoma care, speech rehabilitation, and swallowing techniques
  • Patient may experience early complications such as infection, bleeding, or stoma issues
  • Patient begins the process of adjusting to life with a stoma, including learning how to communicate without a voice box
  • Patient may experience late complications such as stoma stenosis, fistula formation, or tracheal granulomas
  • Patient continues to follow up with healthcare providers for ongoing care and management of stoma-related issues

Overall, the patient’s journey before and after laryngectomy involves a significant amount of physical and emotional adjustment, as well as ongoing support and care from healthcare professionals.

What to Ask Your Doctor

  1. What is a laryngectomy and why is it being recommended for me?
  2. What are the potential risks and complications associated with a laryngectomy?
  3. How long is the recovery process after a laryngectomy and what can I expect during this time?
  4. Will I need any additional support or therapy after the surgery, such as speech therapy or counseling?
  5. What lifestyle changes will I need to make after a laryngectomy, such as changes in diet or breathing techniques?
  6. How often will I need to have follow-up appointments after the surgery?
  7. What signs or symptoms should I watch for that may indicate a complication or problem with my stoma?
  8. Are there any specific activities or restrictions I should be aware of after the surgery?
  9. Will I be able to communicate effectively after the surgery, and if not, what options are available to help me communicate?
  10. Are there any long-term effects or risks associated with having a laryngectomy?

Reference

Authors: Jackson C, Grigg C, Green M, Grigg R. Journal: Aust J Gen Pract. 2019 Jun;48(6):373-377. doi: 10.31128/AJGP-10-18-4723. PMID: 31220883