What is a laryngectomy?
A laryngectomy is a surgical procedure in which all or part of the larynx (voice box) is removed. The larynx is located in the neck and is responsible for breathing, producing sound, and protecting the airway during swallowing.

How long is laryngectomy surgery?
The length of a laryngectomy surgery depends on the type of procedure and the patient’s overall health. On average:

• Total Laryngectomy
  • Duration: 5 to 10 hours
• This includes:
  • Removal of the larynx.
  • Creation of a stoma for breathing.
  • Possible reconstruction of surrounding tissues.
  • Placement of a tracheoesophageal puncture (TEP) for voice restoration (in some cases).
• Partial Laryngectomy
  • Duration: 3 to 6 hours
  • The time varies based on how much of the larynx is removed and whether reconstruction is necessary.
• Extended Procedures
  • If the surgery includes removal of additional structures (e.g., lymph nodes in the neck, called a neck dissection), the surgery can take longer, sometimes 8 to 12 hours.
• Factors That Affect Surgery Time
  Extent of Cancer: Larger tumors or cancers that have spread may require more extensive surgery.
• Reconstruction: If tissue grafts or flaps are needed to rebuild the throat or esophagus, the procedure will take longer.
• Surgeon’s Approach: Some surgeons may use minimally invasive techniques, when possible, which can reduce surgery time.
• Complications: Any unexpected bleeding or anatomical challenges can extend the duration.

Recovery Time in Hospital

• Hospital Stay: Typically, 7 to 14 days after surgery, depending on healing, management of the stoma, and complications.

What is life like after a laryngectomy?
Breathing: Patients breathe through a permanent opening (stoma) in the neck.
Speech: Traditional speech is lost, but alternatives include:
Electrolarynx: A handheld device that produces sound.
Esophageal speech: Speaking by swallowing air and releasing it to create sound.
Tracheoesophageal puncture (TEP): A voice prosthesis inserted between the trachea and esophagus to allow speech.
UltraVoice: A new technology that is so advanced that every tone and inflection of the human voice can be precisely simulated. And a device that is simple to use and easy to maintain while bringing such extraordinary results. Now the laryngectomee can enjoy an enhanced quality of life with near normal speaking abilities.
Lifestyle Changes: Patients need to take precautions to prevent water and debris from entering the stoma and may need to modify physical activities.

Can a laryngectomy be reversed?
No, a laryngectomy cannot be reversed. It is a permanent procedure because the larynx (voice box) is completely or partially removed, and the anatomical structures involved in breathing, speaking, and swallowing are permanently altered.

Why It Can’t Be Reversed:

1. Removal of Critical Structures:
   The larynx, once removed, cannot be replaced or reconstructed to function naturally.
2. Permanent Stoma:
   In a total laryngectomy, a stoma (an opening in the neck) is created for breathing. The airway is permanently separated from the mouth and nose, making reversal anatomically impossible.
3. Functional Changes:
   The nerves, muscles, and cartilage that control voice and breathing through the larynx are often damaged or removed, making it impossible to restore normal function.

Can laryngectomy patients eat?
Yes, laryngectomy patients can eat after recovery, but their ability to swallow may be affected depending on the type of surgery and any additional treatments like radiation. The larynx plays a crucial role in protecting the airway during swallowing, and after its removal, patients may need to adapt to changes in their swallowing function.

How Swallowing Changes After a Laryngectomy

1. Total Laryngectomy:
   • The airway and digestive tract are separated, meaning food and liquids no longer pose a risk of entering the lungs (aspiration).
   • Most patients can eat and drink normally once healed, but the texture of food might need to be adjusted for comfort.
   • Some patients may experience difficulty swallowing (dysphagia) due to scar tissue, radiation, or muscle weakness.
2. Partial Laryngectomy:
   • The airway remains connected to the mouth and throat, so there may be a higher risk of aspiration.
   • Swallowing difficulties are more common, and patients may require a modified diet or swallowing therapy.

Challenges and Solutions

• Dry Mouth: Often caused by radiation therapy, making it harder to swallow.
  • Solution: Use saliva substitutes or drink fluids with meals.
• Scar Tissue or Narrowing: Can make swallowing difficult or uncomfortable.
  • Solution: Dilation procedures or swallowing therapy may help.
• Difficulty Swallowing Certain Foods: Thick, sticky, or dry foods may be challenging.
  • Solution: Start with softer, moist foods and gradually increase the variety as tolerated.

Can you aspirate after total laryngectomy?
No, aspiration (inhalation of food or liquids into the lungs) cannot occur after a total laryngectomy because the airway and the digestive tract are permanently separated.

Why Aspiration Doesn’t Occur:

1. Separation of Airway and Esophagus:
   • After a total laryngectomy, the trachea (windpipe) is rerouted to a permanent opening in the neck called a stoma.
   • The esophagus (food pipe) remains connected to the mouth and throat, but there is no direct connection between the esophagus and the trachea.
   • As a result, food and liquids travel down the esophagus to the stomach without any risk of entering the lungs.
2. No Connection to the Nose or Mouth:
   • The patient no longer breathes through the nose or mouth, eliminating the usual pathways through which aspiration could occur.

Can you put a trach in a laryngectomy?
No, a tracheostomy (trach) is not typically used in a patient who has had a total laryngectomy because the anatomy of the airway is permanently altered. Instead, patients breathe through a stoma, a permanent opening created in the neck that serves as their new airway.

Can you smell after a total laryngectomy?
No, most people cannot smell after a total laryngectomy because the normal pathway for air to pass through the nose is eliminated. Since the sense of smell relies on air carrying odors to the olfactory receptors in the nose, the separation of the airway from the nose and mouth significantly impacts the ability to detect smells.

Why Smell is Affected:

1. Airflow Bypass:
   • After a total laryngectomy, the person breathes entirely through a stoma in the neck, bypassing the nose and mouth.
   • Without air passing through the nasal passages, odors do not reach the olfactory receptors located in the upper part of the nose.
2. Loss of Nasal Airflow:
   • Activities like sniffing, which help draw air into the nose, are no longer possible after the procedure.

Can Smell Be Restored?
While normal smell may not be possible, some patients can regain a limited sense of smell using special techniques or devices:

1. Olfactory Rehabilitation (Smell Training):
   • Techniques like the “Polite Yawn” technique or the “Nasal Airflow-Inducing Maneuver” (NAIM) can help some patients redirect airflow through the nasal passages by manipulating mouth and tongue movements.
   • This method creates negative pressure in the mouth, drawing air into the nose and allowing some odor detection.
2. Artificial Devices:
   • Some external devices or nasal prosthetics are being developed to help laryngectomy patients regain a limited sense of smell, but they are not widely available.

Impact on Quality of Life

The loss of smell can affect:

• Taste perception (since taste and smell are closely linked).
• Detection of hazards (such as smoke, gas leaks, or spoiled food).
• Emotional well-being, as smell is often tied to memories and enjoyment of food and the environment.

Can you smoke after a laryngectomy?
Technically, smoking after a total laryngectomy is possible, but it is extremely dangerous and strongly discouraged for several reasons:

1. Direct Smoke Inhalation Through the Stoma

After a total laryngectomy, patients breathe through a stoma in their neck, bypassing the nose and mouth. If a person smokes, the smoke is directly inhaled into the lungs through the stoma without any filtration by the nose or upper airway.

• This increases the concentration of harmful chemicals entering the lungs.

2. Increased Risk of Complications

Smoking after a laryngectomy can lead to:

• Delayed healing of surgical wounds and the stoma.
• Irritation and infection of the stoma and trachea.
• Tracheal stenosis (narrowing of the trachea), making breathing more difficult.
• Excessive mucus production and frequent coughing, which can irritate the airway.

3. Higher Risk of Cancer Recurrence

Laryngectomy is often performed to treat laryngeal cancer, and continued smoking significantly increases the risk of:

• Cancer recurrence in the lungs, throat, or surrounding tissues.
• Development of secondary cancers (e.g., lung cancer, esophageal cancer).

4. Impact on Overall Health

Smoking increases the risk of:

• Heart disease.
• Chronic obstructive pulmonary disease (COPD).
• Poor quality of life due to breathing difficulties and increased respiratory infections.

Can you talk after a partial laryngectomy?
Yes, many patients can talk after a partial laryngectomy, but the voice may be altered depending on the type and extent of the surgery. In a partial laryngectomy, only part of the larynx (voice box) is removed, allowing the remaining structures to preserve some vocal function. However, the voice may sound different, and speech therapy is often needed to optimize communication.

Voice Changes After Partial Laryngectomy

The degree of voice change depends on factors like:

• How much of the larynx is removed (e.g., vocal cords, epiglottis, or arytenoids).
• Whether one or both vocal cords are preserved.
• The impact of any scar tissue or changes in airflow through the throat.

Common Types of Partial Laryngectomy and Their Impact on Speech

Type of Partial Laryngectomy	Extent of Removal	Effect on Speech
Hemilaryngectomy	One side of the larynx (including one vocal cord) is removed.	Voice is hoarse, weak, or breathy, but speech is usually possible.
Supraglottic Laryngectomy	Structures above the vocal cords (epiglottis, false vocal cords) are removed.	Voice may be relatively normal, but swallowing may be more affected.
Cordectomy	One or part of a vocal cord is removed.	Voice may be weak, hoarse, or breathy.
Frontolateral or Vertical Laryngectomy	Front portion of the larynx is removed.	Voice is typically preserved but may sound rough or low-pitched.

Voice Characteristics After Surgery

• Hoarseness or breathiness due to reduced vocal cord vibration.
• Reduced volume and the ability to project the voice.
• Monotone voice with limited pitch variation.

 Speech Therapy and Rehabilitation
Many patients benefit from working with a speech-language pathologist (SLP) after surgery to:

1. Strengthen the remaining vocal structures.
2. Learn new techniques for voice production.
3. Optimize breathing and articulation.

Does a laryngectomy require a tracheostomy?
Yes, a total laryngectomy typically requires a tracheostomy.

Here’s a breakdown:

• Total Laryngectomy: In this procedure, the entire larynx (voice box) is removed. This disconnects the airway from the mouth and nose.
• Tracheostomy: This is a surgical opening created in the neck to access the trachea (windpipe). A tube is inserted to help with breathing.

Why is a tracheostomy necessary after a total laryngectomy?

• Airway Establishment: The laryngectomy removes the natural pathway for air to enter the lungs. The tracheostomy provides a new opening for breathing.
• Initial Healing: The tracheostomy allows for easier breathing and airway management during the initial healing period after surgery.

Important to Note:

• Temporary vs. Permanent: In some cases, the tracheostomy may be temporary, and the stoma (opening from the laryngectomy) can eventually be used for breathing.
• Voice Rehabilitation: After a laryngectomy, individuals can learn alternative methods of speaking, such as using esophageal speech or electronic devices.

How long can you live with a total laryngectomy?
A total laryngectomy itself doesn’t significantly reduce life expectancy. However, it’s often performed to treat laryngeal cancer, which can impact survival rates.

Here’s a breakdown:

• Laryngectomy vs. Cancer: The surgery itself doesn’t directly shorten life. The underlying health condition, typically laryngeal cancer, is the primary factor influencing survival.
• Cancer Stage: The stage of the cancer at diagnosis significantly impacts prognosis. Early-stage cancers have better survival rates than advanced cancers.
• Overall Health: Other health conditions and overall health can also affect life expectancy.

Important to Note:

• Quality of Life: While a laryngectomy can impact communication and social interactions, modern advancements in rehabilitation and technology have significantly improved the quality of life for individuals who undergo this procedure.

If you have concerns about life expectancy after a laryngectomy, it’s crucial to discuss them with your doctor. They can provide personalized information based on your specific situation and help you understand your prognosis and treatment options.

How long does it take to recover from a laryngectomy?
Recovery from a laryngectomy varies depending on individual factors, but here’s a general timeline:

Initial Recovery:

• Hospital Stay: Typically, 1-2 weeks.
• Feeding Tube: Initially, you’ll be fed through a tube inserted into your nose or stomach. This gradually transitioned to a soft food diet as your throat heals.
• Tracheostomy Care: You’ll learn how to care for your tracheostomy tube and stoma (the opening in your neck).

Short-term Recovery:

• Wound Healing: Your surgical wound will take about 2-3 weeks to heal.
• Speech Therapy: You’ll start speech therapy to learn alternative communication methods like esophageal speech or using electronic devices.
• Physical Therapy: Physical therapy may be recommended to help regain strength and stamina.

Long-term Recovery:

• Full Recovery: It can take several months to fully recover from the surgery and adjust to life after a laryngectomy.
• Ongoing Care: Regular follow-up appointments with your doctor and speech therapist are essential.

Important to Note:

• Individual Variation: Recovery times can vary significantly depending on factors like overall health, cancer stage, and any additional treatments received.
• Quality of Life: While a laryngectomy can impact communication, modern rehabilitation techniques and technology have significantly improved the quality of life for individuals who undergo this procedure.

How to care for laryngectomy tube?
Caring for a laryngectomy tube is essential for maintaining good health and preventing complications. Here are some general guidelines:

Cleaning:

• Frequency: Clean your tube at least twice a day, or more often if needed, especially if you have thick or sticky mucus.
• Supplies: You’ll need a mirror, a nylon tracheostomy brush, normal saline, cotton-tipped applicators, and a clean, dry cloth or paper towel.
• Steps:
  • Wash your hands thoroughly with soap and water.
  • Remove the tube from your stoma.
  • Use the nylon brush to clean the inside of the tube.
  • Rinse the tube under warm running water.
  • Shake out excess water and dry the tube with a clean cloth or paper towel.
  • Clean the skin around your stoma with normal saline using cotton-tipped applicators.
  • Lubricate the outside of the tube with water or ¹ a recommended lubricant.
  • Reinsert the tube into your stoma.

Additional Tips:

• Humidification: Use a humidifier or saline solution to keep your airway moist, especially in dry climates.
• Covering: When going outside in cold weather, wear a stoma cover or scarf to warm the air you breathe.
• Showering: Use a shower guard or cover to protect your stoma from water.
• Regular Check-ups: Schedule regular check-ups with your doctor to monitor your stoma and tube.

How to clean a laryngectomy stoma?
Here are the steps on how to clean a laryngectomy stoma:

Materials needed:

• Mild soap (unscented)
• Warm water
• Soft washcloth or cotton balls
• Saline solution (optional)

Steps:

1. Wash your hands: Wash your hands thoroughly with soap and water to prevent infection.
2. Gently clean the skin: Wet the washcloth or cotton ball with warm water and gently clean the skin around the stoma. You can use a mild soap if needed. Avoid using harsh soaps or scrubbing too hard, as this can irritate the skin.
3. Rinse: Rinse the area with clean water to remove any soap residue.
4. Dry gently: Pat the skin dry with a clean, soft towel. Do not rub the skin, as this can also cause irritation.
5. Moisturize (optional): If the skin around the stoma feels dry, you can apply a thin layer of fragrance-free moisturizer.

Additional Tips:

• Avoid touching the stoma directly: If you need to touch the stoma, wash your hands thoroughly first.
• Keep the stoma dry: Avoid getting water directly into the stoma. When showering, use a shower shield or cover to protect the stoma.
• Monitor for signs of infection: Look for signs of infection, such as redness, swelling, pus, or increased pain. If you notice any of these signs, contact your doctor immediately.

Remember:

• Follow your doctor’s specific instructions: Your doctor may have specific instructions for cleaning your stoma, so be sure to follow their advice.
• If you have any questions or concerns, consult your doctor: They can provide you with personalized advice and guidance.

What is a partial laryngectomy?
Only a portion of the larynx is removed.

The patient may retain some ability to speak and breathe through the mouth and nose.

What is a total laryngectomy?
The entire larynx is removed.

The patient will no longer be able to speak naturally or breathe through the mouth or nose. Instead, they breathe through a hole (stoma) created in the neck.

What is the difference between a tracheostomy and a laryngectomy?

Key Differences Between a Tracheostomy and a Laryngectomy Stoma:

Tracheostomy	Laryngectomy Stoma
Temporary or permanent opening made in the trachea below the larynx.	Permanent removal of the larynx with a direct airway through the stoma.
The upper airway (mouth, nose, and larynx) remains intact and connected to the trachea.	The upper airway is permanently separated from the trachea.
Can be closed once the tracheostomy tube is removed if no longer needed.	Cannot be closed; it is a permanent airway.
Requires a tracheostomy tube to keep the airway open.	Usually does not require a tube unless complications arise; instead, a laryngectomy tube or stoma button may be used.

What other procedure will usually be completed with a laryngectomy?
A tracheostomy is the most common procedure performed alongside a laryngectomy. This involves creating an opening in the neck directly into the trachea (windpipe) to allow for breathing. A tube is inserted into this opening to help with airflow.

Tracheostomy

This is necessary because a laryngectomy removes the natural pathway for air to enter the lungs. The tracheostomy provides a new airway.

In some cases, depending on the extent of the surgery and the specific needs of the patient, other procedures may also be considered, such as:

• Neck dissection: This procedure removes lymph nodes in the neck to check for cancer spread.
• Pharyngectomy: This procedure removes part of the pharynx (throat) if cancer has spread to this area.

Why would you need a laryngectomy?
A laryngectomy is typically performed to treat:

• Laryngeal cancer (most common reason).
• Severe trauma or injury to the larynx.
• Radiation damage to the larynx.
• Rare conditions like recurrent papillomatosis (benign tumors).

Are vocal folds removed in a total laryngectomy?
Yes, in a total laryngectomy, the entire larynx (voice box) is removed. This includes the vocal folds, which are responsible for producing sound. As a result, individuals who undergo a total laryngectomy will lose their natural voice and will need to learn alternative methods of communication.

Can a laryngectomy patient cough and deep breath?
Yes, a laryngectomy patient can cough and take deep breaths. After the surgery, they will breathe through a stoma in their neck, and this allows for normal respiratory functions, including coughing and deep breathing.

In fact, coughing and deep breathing are important for clearing mucus from the lungs and preventing respiratory infections. However, it may take some time for the patient to adjust to breathing through the stoma and to develop effective coughing techniques.

Can a total laryngectomy use trans esophageal puncture?
Yes, a transesophageal puncture (TEP) can be used after a total laryngectomy to help patients regain the ability to speak. A TEP involves creating a small hole between the trachea and the esophagus. This allows air to be redirected from the trachea into the esophagus, where it can vibrate the tissues and produce sound. A one-way valve is inserted into the puncture to prevent food and liquids from entering the airway.

This procedure is typically performed several weeks or months after the laryngectomy to allow the surgical site to heal. It is a relatively simple procedure that can significantly improve the quality of life for laryngectomy patients.

However, it’s important to note that not all laryngectomy patients are suitable for a TEP. The decision to proceed with this procedure is made on an individual basis, considering factors such as the patient’s overall health, the extent of the surgery, and their personal preferences.

Can flap for laryngectomy fail weeks after surgery?
Yes, a flap for laryngectomy can fail weeks or even months after surgery. This complication is known as a pharyngocutaneous fistula. It occurs when there’s a breakdown in the tissue between the pharynx (throat) and the skin, leading to a connection between the two.

Factors that can increase the risk of flap failure include:

• Radiation therapy: Previous radiation therapy to the neck can make tissues more fragile and prone to breakdown.
• Poor blood supply to the flap: This can occur if the blood vessels supplying the flap are damaged or compromised.
• Infection: Infection can weaken the tissues and increase the risk of fistula formation.
• Patient factors: Factors such as smoking, diabetes, and poor overall health can also contribute to flap failure.

If a flap failure occurs, it can lead to several complications, including:

• Difficulty swallowing: Food and liquids can leak into the neck wound.
• Respiratory problems: Infection or inflammation can affect breathing.
• Skin breakdown: The skin around the stoma may become irritated and infected.

If you experience any signs of flap failure, such as increased pain, drainage, or difficulty swallowing, it’s important to contact your doctor immediately. Treatment for a pharyngocutaneous fistula may involve additional surgery, antibiotics, or other interventions.

Can I run after a laryngectomy?
Yes, you can run after a laryngectomy. In fact, physical activity like running can be beneficial for your overall health and recovery. However, it’s important to consult with your doctor before starting any new exercise program, especially after major surgery.

Here are some things to keep in mind:

• Start slowly: Begin with gentle exercises like walking and gradually increase the intensity and duration as your body heals.
• Listen to your body: Don’t push yourself too hard, especially in the early stages of recovery.
• Protect your stoma: Wear a stoma cover or scarf to protect your stoma from dust, wind, and cold air.
• Stay hydrated: Drink plenty of fluids to avoid dehydration.
• Monitor your breathing: Be aware of your breathing and adjust your pace accordingly.

Remember, everyone’s recovery process is different. It’s essential to listen to your body and seek guidance from your healthcare team to ensure a safe and successful return to physical activity.

Can laryngectomy patients swim?
Yes, laryngectomy patients can swim, but with certain precautions.

To ensure safety, it’s crucial to use specialized equipment designed for individuals with a tracheostomy. This equipment is designed to keep water out of the stoma, preventing potential infections and complications.

Here are some key points to remember:

• Consult with a Healthcare Professional: Always consult with your doctor or speech-language pathologist before starting any new physical activity, including swimming.
• Specialized Equipment: Use a stoma cover or a specialized swimming device that can protect your stoma from water.
• Supervised Swimming: It’s recommended to swim in a supervised environment, such as a pool with lifeguards, to minimize risks.
• Start Slowly: Begin with short swimming sessions and gradually increase the duration as you become more comfortable.

By taking these precautions, many laryngectomy patients can enjoy the benefits of swimming, including physical exercise and relaxation.

Can laryngectomy reduce my lifespan?
A laryngectomy itself doesn’t significantly reduce lifespan. The procedure is often performed to treat laryngeal cancer, which can impact life expectancy. However, the primary factor influencing survival is the stage of the cancer at diagnosis.

Early-stage cancers have a much better prognosis than advanced cancers. With early detection and treatment, including laryngectomy, many people can live long and fulfilling lives after the surgery.

It’s important to consult with your doctor for a personalized assessment and to discuss any concerns you may have about your specific situation.

Can you breathe through mouth and nose after laryngectomy?
No, you cannot breathe through your mouth and nose after a total laryngectomy.

A total laryngectomy removes the entire larynx (voice box), which includes the structures that connect your mouth and nose to your lungs. As a result, you will breathe through a stoma (an opening) in your neck. This stoma is directly connected to your windpipe (trachea), allowing air to flow in and out of your lungs.

While this may seem different, your lungs will continue to function normally. However, it’s important to take care of your stoma and follow your healthcare provider’s instructions to ensure optimal breathing and prevent complications.

Can you drive after total laryngectomy?
You should not drive immediately after a laryngectomy.

Several factors prevent immediate driving:

• Medication: Post-surgery medication can impair your ability to react quickly and safely.
• Physical Recovery: The surgery and recovery process can leave you feeling weak and fatigued.
• Respiratory Changes: Breathing through a stoma can affect your ability to respond to sudden events on the road.

When can you start driving again?

You should consult with your doctor to determine when it’s safe to drive. Factors like pain medication, overall recovery, and any cognitive side effects from medication or the surgery itself will influence this decision.

Generally, you might be able to drive again after a few weeks, provided you:

• Are off pain medication
• Feel physically strong enough
• Can react quickly to unexpected situations

Always prioritize your safety and the safety of others. If you have any doubts, it’s best to wait until you’re fully recovered before driving.

Can you eat spicy foods after laryngectomy?
Whether or not you can eat spicy foods after a laryngectomy depends on several factors, including the individual’s healing process and tolerance.

While spicy foods may not be directly harmful, they can irritate the delicate tissues in the throat and mouth, which can be sensitive after surgery. It’s generally advisable to avoid spicy foods, especially in the initial stages of recovery, to minimize discomfort and potential complications.

It’s best to consult with your doctor or a speech-language pathologist for personalized advice. They can provide specific recommendations based on your individual situation and healing progress.

As you recover, you may be able to gradually introduce spicy foods into your diet, but it’s important to listen to your body and adjust your intake accordingly.

Can you have asthma after total laryngectomy?
No, you cannot have asthma after a total laryngectomy.

Asthma is a respiratory condition that affects the airways in the lungs. A laryngectomy removes the larynx (voice box), which is part of the upper respiratory tract. It doesn’t directly affect the lower respiratory tract, where asthma originates.

However, it’s important to note that individuals who have undergone a laryngectomy may experience respiratory issues due to changes in their breathing patterns and the potential for mucus buildup in the lungs. These issues are typically managed through specific breathing exercises and respiratory therapy.

If you’re experiencing respiratory symptoms after a laryngectomy, it’s crucial to consult with your healthcare provider to determine the underlying cause and receive appropriate treatment.

Can you laugh after a total laryngectomy?
Yes, you can still laugh after a total laryngectomy. While you won’t produce the same sound as before, you can still express emotions like laughter. Your body will find alternative ways to express these emotions, often through facial expressions, gestures, and sounds that may be unique to you.

It’s important to note that recovery from a laryngectomy takes time, and learning new ways to communicate can be a challenging process. However, with the help of speech therapy and rehabilitation, many individuals can adapt and lead fulfilling lives.

Can you sing after a laryngectomy?
Unfortunately, singing in the traditional sense isn’t possible after a total laryngectomy.

A total laryngectomy removes the larynx (voice box), which is essential for producing sound. However, with advancements in medical technology and rehabilitation techniques, laryngectomy patients can still find ways to express themselves musically.

Here are some alternative approaches:

• Electronic Devices: Many laryngectomy patients use electronic devices that convert typed text into synthesized speech. These devices can be used to create music and songs.
• Esophageal Speech: Some individuals learn to speak by creating vibrations in their esophagus. While this isn’t traditional singing, it can be used to create musical sounds and express emotions.

While these methods may not replicate the full experience of singing, they offer opportunities for creative expression and musical enjoyment.

Do you lose your thyroid with a laryngectomy?
No, a laryngectomy does not remove the thyroid gland.

Does a laryngectomy affect digestion?
Yes, a laryngectomy can indirectly affect digestion.

While the surgery itself doesn’t directly impact the digestive system, the changes in swallowing mechanics and overall health can lead to digestive issues. Here’s how:

• Swallowing Difficulties: The removal of the larynx can affect the coordination of swallowing muscles. This can lead to difficulty swallowing, aspiration (food or liquid entering the lungs), and decreased food intake.
• Dietary Changes: To reduce the risk of aspiration, laryngectomy patients often need to modify their diet, consuming softer foods and smaller portions. This can sometimes lead to dietary imbalances and digestive problems.
• Reduced Saliva Production: Dry mouth, a common side effect of laryngectomy, can affect digestion. Saliva plays a crucial role in breaking down food and protecting the digestive tract.
• Psychological Factors: The stress and anxiety associated with the surgery and its impact on quality of life can also influence digestion.

To manage these potential digestive issues, it’s essential to:

• Consult with a Speech-Language Pathologist: They can provide guidance on swallowing techniques and dietary modifications.
• Maintain Good Oral Hygiene: Regular dental check-ups and proper oral hygiene practices can help prevent infections and promote healthy digestion.
• Stay Hydrated: Drinking plenty of fluids can help with digestion and saliva production.
• Manage Stress: Techniques like relaxation exercises, meditation, or yoga can help reduce stress and its impact on digestion.

Can I be active after laryngectomy?
Yes, you can be quite active after a laryngectomy. While the extent of your activity will depend on individual factors like overall health and the specific nature of the surgery, many people are able to return to many of their favorite activities.

Here are some activities that laryngectomy patients often enjoy:

• Walking: A great way to stay active and improve cardiovascular health.
• Swimming: A low-impact exercise that can be beneficial for both physical and mental health.
• Cycling: A good option for those who enjoy outdoor activities.
• Yoga and Pilates: These practices can improve flexibility, strength, and balance.
• Golf: A popular choice for many, as it can be adapted to different fitness levels.

However, it’s important to consult with your doctor or physical therapist before starting any new exercise program. They can provide personalized advice and help you develop a safe and effective exercise plan.

Remember to listen to your body and avoid overexerting yourself, especially in the early stages of recovery. As you heal, you can gradually increase the intensity and duration of your workouts.

How common is laryngectomy?
Laryngectomy is not a common procedure. It’s typically performed to treat advanced laryngeal cancer, which itself is relatively rare. While the exact number of laryngectomies performed annually varies, it’s a relatively small number compared to other surgical procedures.

However, it’s important to note that advancements in medical technology and treatment options have led to a decrease in the number of laryngectomies performed each year. Less invasive treatments, such as radiation therapy and chemotherapy, are now often used to treat early-stage laryngeal cancer.

How dangerous is a laryngectomy?
A laryngectomy is a major surgery, and like any surgery, it carries risks. However, with modern surgical techniques and postoperative care, the risks can be minimized.

Potential risks and complications of a laryngectomy include:

• Infection: As with any surgery, there’s a risk of infection at the surgical site.
• Bleeding: Excessive bleeding can occur during or after surgery.
• Blood clots: Blood clots can form in the legs or lungs.
• Damage to nearby organs: There’s a risk of damage to the esophagus, trachea, or nerves during surgery.
• Difficulty swallowing: This can lead to weight loss and malnutrition.
• Respiratory problems: Breathing difficulties can occur, particularly if the airway is compromised.
• Voice and speech changes: The loss of the larynx will affect speech, and patients will need to learn alternative communication methods.
• Psychological impact: The physical and emotional changes associated with a laryngectomy can be significant.

It’s important to note that the specific risks and complications can vary depending on individual factors, such as overall health, the extent of the surgery, and the surgeon’s experience.

Before undergoing a laryngectomy, it’s crucial to discuss the potential risks and benefits with your doctor. They can provide more specific information about your individual situation and help you make informed decisions.

How do you treat sleep apnea in a laryngectomy patient?
Treating Sleep Apnea in Laryngectomy Patients

Sleep apnea can be a concern for laryngectomy patients, especially those who rely on a tracheostomy tube for breathing. The most common treatment for sleep apnea in this population is continuous positive airway pressure (CPAP).

How CPAP Works for Laryngectomy Patients:

A CPAP machine delivers a continuous flow of air pressure through a mask worn over the nose and mouth. This pressure helps to keep the airway open, preventing the soft tissues in the throat from collapsing and blocking airflow.

Specific Considerations for Laryngectomy Patients:

• Tracheostomy Tube: The CPAP mask can be adjusted to accommodate the tracheostomy tube.
• Humidification: Humidification is crucial to prevent dryness and irritation of the airways, especially for laryngectomy patients.
• Positive Pressure Ventilation (PPV): In severe cases, PPV may be necessary, which involves using a ventilator to assist with breathing.

Other Treatment Options:

• Oral Appliances: While less common for laryngectomy patients, oral appliances can sometimes be used to reposition the jaw and tongue, helping to keep the airway open.
• Surgery: In rare cases, surgery may be considered to correct anatomical abnormalities that contribute to sleep apnea.

It’s important to consult with a sleep specialist to determine the best treatment approach for your specific needs. They can assess your sleep patterns, recommend appropriate treatment options, and monitor your progress.

Remember, early diagnosis and treatment of sleep apnea can significantly improve your quality of life and overall health.

How to assess laryngectomy nerve function?
Assessing Nerve Function After Laryngectomy

Assessing nerve function after a laryngectomy is crucial to identify any potential damage to cranial nerves that could impact swallowing, speech, and other functions. Here are some common methods used to assess nerve function:

Physical Examination

A healthcare professional will conduct a thorough physical examination, focusing on the following areas:

• Cranial Nerve X (Vagus Nerve): This nerve controls the muscles of the pharynx and larynx. Its function can be assessed by observing the patient’s ability to:
  • Swallow
  • Cough
  • Produce sounds
  • Move the soft palate
• Cranial Nerve XI (Accessory Nerve): This nerve controls the sternocleidomastoid and trapezius muscles. Its function can be assessed by:
  • Checking for shoulder shrug strength
  • Evaluating head turning strength
• Cranial Nerve XII (Hypoglossal Nerve): This nerve controls the tongue muscles. Its function can be assessed by:
  • Observing tongue movement
  • Checking tongue strength

Swallowing Evaluation

A speech-language pathologist can conduct a swallowing evaluation to assess the following:

• Oral Phase: The ability to chew and manipulate food in the mouth.
• Pharyngeal Phase: The ability to initiate the swallow reflex and propel food through the pharynx.
• Esophageal Phase: The ability to move food through the esophagus into the stomach.

Videofluoroscopic Swallow Study (VFSS)

A VFSS is a diagnostic test that uses X-ray imaging to visualize the swallowing process. It can help identify any swallowing difficulties and determine the appropriate treatment plan.

Electromyography (EMG)

EMG is a diagnostic test that measures the electrical activity of muscles. It can be used to assess the function of the muscles innervated by the cranial nerves involved in swallowing and speech.

By combining these assessment methods, healthcare professionals can accurately assess nerve function after a laryngectomy and develop appropriate rehabilitation plans to optimize the patient’s quality of life.

How to care for laryngectomy patient?
Caring for a laryngectomy patient requires a combination of physical care, emotional support, and understanding. Here’s a breakdown of key care aspects:

Physical Care

• Stoma Care:
  • Keep the stoma clean and dry.
  • Use saline solution to clean the area around the stoma.
  • Avoid using harsh soaps or alcohol-based cleansers.
  • Protect the stoma from dust and cold air by using a stoma cover or scarf.
• Tracheostomy Tube Care:
  • Clean the tube regularly as instructed by the healthcare provider.
  • Use a sterile technique to change the tube.
  • Monitor for signs of infection, such as increased redness, swelling, or drainage.
• Respiratory Care:
  • Encourage deep breathing exercises and coughing to clear secretions.
  • Use a humidifier to keep the air moist.
  • Monitor for signs of respiratory distress, such as rapid breathing, wheezing, or difficulty breathing.
• Swallowing and Nutrition:
  • Assist with feeding as needed, especially in the initial stages of recovery.
  • Monitor for signs of aspiration, such as coughing or choking during or after eating.
  • Consult with a speech-language pathologist for swallowing therapy.
• Pain Management:
  • Administer pain medication as prescribed by the doctor.
  • Monitor for pain and discomfort and report any changes to the healthcare provider.

Emotional Support

• Communication:
  • Learn alternative communication methods, such as writing, gestures, or using a communication device.
  • Be patient and understanding when communicating.
  • Provide emotional support and reassurance.
• Psychological Support:
  • Encourage participation in support groups or counseling.
  • Help the patient adapt to their new normal and cope with emotional challenges.
• Social Support:
  • Facilitate social interactions and connections with family and friends.
  • Encourage participation in social activities and hobbies.

Remember:

• Follow Healthcare Provider’s Instructions: Adhere to the specific care plan provided by the healthcare team.
• Maintain Good Hygiene: Practice good hand hygiene to prevent infection.
• Monitor for Complications: Be vigilant for signs of infection, bleeding, or other complications.
• Promote Independence: Encourage the patient to be as independent as possible.

By providing comprehensive care, you can help a laryngectomy patient regain their quality of life and adapt to their new circumstances.

Is a laryngectomy tube permanent?
No, a laryngectomy tube is not permanent.

After the initial healing period, the tracheostomy tube is typically removed. The stoma (the opening in the neck) remains open, and patients breathe directly through it. A small, flexible silicone tube may be placed in the stoma to keep it open, but this is not always necessary.

The long-term management of the stoma involves regular cleaning and care to prevent infection. Patients will need to learn how to manage their stoma independently and take precautions to protect it from dirt, water, and cold air.

Is laryngectomy a disability?
Yes, a laryngectomy can be considered a disability.

The removal of the larynx significantly impacts a person’s ability to communicate, breathe, and swallow. These limitations can affect various aspects of daily life, including social interactions, employment, and overall quality of life.

While many laryngectomy patients can adapt and lead fulfilling lives with the help of rehabilitation and assistive devices, the condition can still be classified as a disability.

It’s important to note that disability status can vary from person to person, and it’s often determined by individual circumstances and the specific challenges faced.

Is the epiglottis removed in a laryngectomy?
Yes, the epiglottis is removed during a total laryngectomy.

A total laryngectomy involves the complete removal of the larynx, which includes the vocal cords, the thyroid cartilage, the cricoid cartilage, and the epiglottis. The epiglottis is a flap of tissue that covers the trachea during swallowing, preventing food and drink from entering the lungs.

What causes hypoxia after a total laryngectomy?
Hypoxia after a total laryngectomy can occur due to several factors:

1. Airway Obstruction:

• Mucus Plugs: Mucus can accumulate in the tracheostomy tube or stoma, blocking airflow.
• Tube Displacement: The tracheostomy tube may become dislodged or blocked.
• Tracheomalacia: Weakening of the tracheal wall can lead to airway collapse, especially during inspiration.

2. Respiratory Muscle Weakness:

• Post-operative Weakness: Muscles involved in breathing may be weakened due to surgery or anesthesia.
• Neuromuscular Disorders: Underlying conditions like neuromuscular diseases can impair respiratory muscle function.

3. Pulmonary Complications:

• Pneumonia: Infection in the lungs can impair oxygen exchange.
• Pulmonary Embolism: Blood clots can block blood flow to the lungs.

4. Inadequate Oxygen Delivery:

• Poor Oxygenation: Inefficient oxygen transfer from the lungs to the bloodstream.
• Anemia: Low levels of hemoglobin can reduce oxygen-carrying capacity.

To prevent hypoxia after a laryngectomy, it’s crucial to:

• Maintain a clear airway: Regular suctioning of the tracheostomy tube and stoma, and proper tube care.
• Respiratory Therapy: Chest physiotherapy and breathing exercises to improve lung function.
• Monitor Oxygen Saturation: Regular pulse oximetry to assess oxygen levels.
• Address Underlying Conditions: Managing any underlying medical conditions that may contribute to hypoxia.
• Prompt Medical Attention: Seek immediate medical help for any signs of respiratory distress.

By taking these precautions and working closely with healthcare professionals, laryngectomy patients can minimize the risk of hypoxia and maintain optimal respiratory function.

What is a glosso laryngectomy?
A glosso-laryngectomy is a surgical procedure that involves the removal of both the tongue (glossectomy) and the larynx (laryngectomy). This type of surgery is typically performed to treat advanced head and neck cancers, particularly those involving the base of the tongue and the larynx.

The removal of both organs has significant implications for speech, swallowing, and overall quality of life. Patients who undergo this procedure will require extensive rehabilitation, including speech therapy and nutritional counseling, to adapt to the significant changes in their anatomy and function.

What is a radical laryngectomy?
Radical Laryngectomy:

• • Removes the entire larynx (voice box).
  • Also removes surrounding tissues, including lymph nodes in the neck.
  • This is often done to treat advanced cancers that have spread to nearby lymph nodes.

In essence, a radical laryngectomy is a more extensive procedure than a total laryngectomy, as it involves the removal of not only the larynx but also additional surrounding tissues. Both procedures result in the loss of the natural voice and require patients to learn alternative methods of communication.

What is a salvage laryngectomy?
A salvage laryngectomy is a surgical procedure performed to remove the larynx (voice box) after a previous attempt to preserve it with radiation therapy or chemotherapy has failed.

This is typically done when the cancer has recurred or has not responded adequately to non-surgical treatments.

Compared to a primary laryngectomy (performed as the initial treatment), a salvage laryngectomy often carries a higher risk of complications, such as:

• Infection: Due to the previous radiation therapy, the tissues may be more susceptible to infection.
• Healing difficulties: The radiation can damage the tissues, making healing more challenging.
• Pharyngocutaneous fistula: A hole may form between the pharynx (throat) and the skin, leading to leakage of saliva and food.

Despite these challenges, salvage laryngectomy can be a life-saving procedure for patients with recurrent or persistent laryngeal cancer.

What is a subtotal laryngectomy?
A subtotal laryngectomy is a surgical procedure where only a portion of the larynx (voice box) is removed. This is typically performed for early-stage laryngeal cancer, aiming to preserve as much of the laryngeal function as possible.

There are several types of subtotal laryngectomies, including:

• Supraglottic laryngectomy: Removes the epiglottis, aryepiglottic folds, and false vocal cords.
• Partial laryngectomy: Removes a portion of the vocal cords, often one side.
• Supracricoid laryngectomy: Removes the epiglottis, aryepiglottic folds, and the upper part of the thyroid cartilage.

The specific type of subtotal laryngectomy performed depends on the location and extent of the cancer. While this procedure preserves some laryngeal function, it may still impact voice quality and swallowing. Patients who undergo a subtotal laryngectomy often require speech therapy to improve their voice and swallowing abilities.

What is a supracricoid laryngectomy?
A supracricoid laryngectomy is a surgical procedure where the upper part of the larynx, including the epiglottis, aryepiglottic folds, and the anterior portion of the vocal folds, is removed. This procedure is typically used for early-stage laryngeal cancer that is confined to the supraglottic region.

The goal of a supracricoid laryngectomy is to remove the cancerous tissue while preserving as much of the laryngeal function as possible. This type of surgery often allows patients to maintain their natural voice and swallowing ability. However, the long-term voice quality may be affected, and some patients may require speech therapy to improve their voice and swallowing function.

What is a supraglottic laryngectomy?
A supraglottic laryngectomy is a surgical procedure where the upper part of the larynx (voice box) is removed. This part, called the supraglottis, includes the epiglottis, aryepiglottic folds, and false vocal cords.

This procedure is typically performed to treat early-stage laryngeal cancer that is confined to the supraglottic region. By removing the cancerous tissue while preserving the vocal cords, this surgery aims to maintain the patient’s voice and swallowing function.

However, it’s important to note that while this procedure can preserve vocal function, it may still impact voice quality and swallowing. Patients often require speech therapy to help them adjust to any changes in their voice and swallowing abilities.

What is a TEP laryngectomy?
TEP stands for Tracheoesophageal Puncture. It’s a surgical procedure that creates a connection between the trachea (windpipe) and the esophagus. This connection allows air to be redirected from the trachea into the esophagus, where it can vibrate the tissues and produce sound.

A TEP valve is inserted into this connection to control the airflow. This valve allows the patient to speak after a total laryngectomy, where the larynx (voice box) has been removed.

A TEP is not a type of laryngectomy itself, but rather a procedure to restore speech after a laryngectomy.

What is cricopharyngeal myotomy laryngectomy?
Cricopharyngeal myotomy is a surgical procedure where the cricopharyngeal muscle, a muscle that helps control swallowing, is partially cut. This procedure is often performed in conjunction with a laryngectomy to improve swallowing function and reduce the risk of aspiration (food or liquid entering the lungs).

By relaxing the cricopharyngeal muscle, the procedure can help to:

• Improve swallowing: This can make it easier for patients to swallow food and liquids, reducing the risk of aspiration.
• Enhance voice quality: By reducing muscle tension in the upper esophagus, it can improve the quality of voice produced through esophageal speech.

The decision to perform a cricopharyngeal myotomy is made on a case-by-case basis, often based on the individual patient’s needs and the surgeon’s assessment.

What is the difference between a laryngectomy and tracheostomy?
Laryngectomy and tracheostomy are two different surgical procedures, though they both involve creating an opening in the neck.

Laryngectomy

• Removes the entire larynx (voice box).
• Disconnects the upper airway from the lower airway.
• Requires a permanent opening in the neck (stoma) for breathing.
• Results in the loss of the natural voice.

Tracheostomy

• Creates a temporary or permanent opening directly into the trachea (windpipe).
• The larynx remains intact.
• Used to bypass the upper airway for breathing, often due to obstruction or respiratory failure.
• May be reversible, and the tracheostomy tube can eventually be removed.

Key differences:

Feature	Laryngectomy	Tracheostomy
Organ Removed	Larynx	None
Airway Connection	Disconnected	Intact
Stoma	Permanent	Temporary or permanent
Voice	Lost	Preserved

What is the neopharyx in laryngectomy?
The neopharynx is not a specific anatomical structure. It’s a term used to describe the area of the pharynx (throat) that remains after a total laryngectomy.

In essence, it’s the post-surgical anatomical configuration of the remaining pharynx after the larynx has been removed. It’s a dynamic area that plays a crucial role in swallowing and, in some cases, in alternative voice production techniques like esophageal speech.

What muscles are removed in a laryngectomy?
A laryngectomy doesn’t directly remove individual muscles. Instead, it removes the entire larynx, a complex structure composed of cartilage, muscles, and ligaments.

Here are the primary structures removed during a total laryngectomy:

• Thyroid cartilage: The largest cartilage of the larynx.
• Cricoid cartilage: The ring-shaped cartilage below the thyroid cartilage.
• Arytenoid cartilages: Paired cartilages that pivot to open and close the vocal cords.
• Vocal cords: The bands of tissue that vibrate to produce sound.
• Epiglottis: A flap of tissue that covers the trachea during swallowing.
• Muscles: The intrinsic and extrinsic laryngeal muscles that control the movement of the vocal cords and the position of the larynx.

By removing the entire larynx, the patient loses the ability to produce sound through vocal cord vibration. This necessitates the use of alternative communication methods, such as esophageal speech or electronic devices.

What type of doctor performs a laryngectomy?
A laryngectomy is typically performed by an Otolaryngologist, also known as an Ear, Nose, and Throat (ENT) doctor.

ENT doctors specialize in diagnosing and treating disorders of the head and neck, including the larynx (voice box). They have the expertise to perform complex surgical procedures like laryngectomies.

Where to buy laryngectomy supplies?
You can purchase laryngectomy supplies from a variety of sources, including:

1. Medical Supply Stores:
   • Local Stores: Check with your local medical supply store or pharmacy. They may carry basic supplies like stoma covers, neck scarves, and cleaning solutions.
   • Online Retailers: Many online retailers specialize in medical supplies and offer a wide range of laryngectomy products. Some popular options include:
     • Atos Medical: A leading provider of laryngectomy products, including voice prostheses, stoma covers, and tubes.
     • InHealth: Offers a variety of laryngectomy supplies, such as stoma filters, tubes, and voice prostheses.
     • Amazon: You can find a variety of laryngectomy supplies on Amazon, including stoma covers, cleaning solutions, and other accessories.

2. Healthcare Provider:
   • Your healthcare provider, such as a speech-language pathologist or otolaryngologist, can often provide or recommend specific suppliers for laryngectomy supplies. They may also be able to help you obtain supplies through insurance or other programs.

Important Considerations:

• Consult with your healthcare provider: Before purchasing any laryngectomy supplies, consult with your healthcare provider to ensure that you are purchasing the correct products and using them properly.
• Insurance Coverage: Check with your insurance provider to determine which laryngectomy supplies are covered by your insurance plan.
• Quality and Safety: When purchasing laryngectomy supplies, it is important to choose high-quality products from reputable suppliers. Look for products that are made from safe and durable materials.

Which nursing concern takes priority after a laryngectomy?
The primary concern after a laryngectomy is ensuring a patent airway. This includes:

• Monitoring respiratory status: Closely observing respiratory rate, rhythm, and depth.
• Maintaining airway patency: Preventing mucus plugs and ensuring the tracheostomy tube is functioning correctly.
• Suctioning as needed: Removing secretions from the airway to prevent obstruction.
• Humidifying the air: Keeping the airway moist to prevent dryness and irritation.

Other important nursing concerns include:

• Pain management: Administering pain medication as prescribed and monitoring for pain.
• Wound care: Keeping the surgical site clean and dry to prevent infection.
• Nutritional support: Assisting with feeding and monitoring for adequate intake.
• Communication: Facilitating communication with the patient and addressing emotional needs.
• Infection prevention: Implementing strict infection control measures.

Will a total laryngectomy cure the cancer?
A total laryngectomy can cure laryngeal cancer, but it depends on several factors:

• Stage of Cancer: The stage of the cancer at diagnosis is a crucial factor. Early-stage cancers have a higher cure rate than advanced-stage cancers.
• Complete Removal of Cancer: The surgeon must ensure that all cancerous tissue is removed during the procedure.
• Individual Response to Treatment: Each person’s response to treatment can vary. Factors like overall health, age, and other medical conditions can influence the outcome.
• Post-Surgical Treatment: Additional treatments, such as radiation therapy or chemotherapy, may be necessary to eliminate any remaining cancer cells.

While a laryngectomy can be a curative treatment, it’s important to consult with a healthcare professional for a personalized assessment and to discuss the potential risks and benefits of the procedure.

What speech rehab for total laryngectomy sounds the most normal?
UltraVoice! A new speech generating device, UltraVoice Plus has been developed which presents another option enabling laryngectomees to speak. This new device consists of an oral unit which is worn inside the mouth and a controller which transmits radio waves to the oral unit. The radio waves carry the tone of the human voice which is reproduced in the mouth by the oral unit. Because the sound is created within the vocal tract, it is significantly more natural and intelligible than external units. In addition, it has been designed to alleviate some of the contraindications associated with the other technologies.