What is a laryngectomy?

A laryngectomy is a surgical procedure to remove the larynx (the voice box). This is most commonly performed to treat advanced laryngeal cancer or severe damage to the throat. In the UK, about 600–800 people undergo a total laryngectomy every year. A total laryngectomy removes the entire voice box, while a partial laryngectomy removes only a portion.

During the operation, the airway is separated from the mouth and nose. To allow you to breathe safely, an opening is created at the base of the neck, known as a stoma.

You can read a more details guide on laryngectomy on the MacMillan website

How Life Changes

It is important to understand that while life changes after a laryngectomy, it certainly does not stop. Here are some of the main changes you should expect.

Breathing

You will now breathe through the stoma in your neck instead of your nose and mouth. This also means that when you cough or sneeze the mucus will be expelled through the stoma. The mouth and nose are now completely disconnected from the trachea and lungs. It is extremely important to know that the stoma is the only place you can breathe from, this means the stoma can never be obstructed and water must never enter the stoma. This means that swimming is not recommended or possible without the use of very specialised equipment which can be used at your own risk.

Speaking

As the voice box is removed, your natural voice will change. However, there are several ways to speak again. The most common option is a Tracheoesophageal Puncture (TEP) where a small valve is inserted to between the trachea and the oesophagus. Some people may use an electrolarynx device, these are pressed to the neck and use vibrations which can be shaped by the mouth and lips creating a voice. Lastly esophageal speechwhich is a technique where you move air down into your food pipe (oesophagus). The air passes through the muscles in your throat and causes vibrations. You learn to use these vibrations and turn them into speech by moving your mouth and lips as you would when speaking normally. This is quite a challenging method to learn however it does not require any upkeep such as with the TEP.

Eating & Drinking

While the anatomy is altered, swallowing usually remains possible. Some patients may find swallowing hard or even impossible, you can have additonal procedures to help with swallowing such as a dilation or botox injections to relax the muscles but this all depends on the individual and you will be led by your medical team.Your "food pipe" (oesophagus) remains intact. Most people return to a normal diet once they have healed from the surgery however you may also need to use a feeding tube directly into the stomach. You may find increased acid reflux due to the reconstructive surgery, this can be managed by medication.