A total laryngectomy is a type of surgery carried out in the advanced stages of cancer. The procedure consists of removing your voice box – also called the larynx. After a laryngectomy, breathing happens through an opening in the neck instead of the nose and mouth.
Undergoing a total laryngectomy can be an overwhelming experience, but you shouldn’t feel cut off. There are more than 100,000 people worldwide who have undergone the same procedure and proven it’s possible to maintain your quality of life.
The larynx plays several vital roles. It houses the vocal folds that make our voice sound. The larynx also aids us in breathing and swallowing. Therefore, removal of the voice box not only leads to changes in the voice, but also causes changes in breathing, swallowing, and smelling.
Your new voice
We depend on our voices to express our thoughts and feelings. Losing your natural voice can at first be quite upsetting, and have a large effect on your ability to communicate as well as your sense of identity. But the good news is that there are quite a number of ways to regain your voice.
There are mainly three voicing methods that can be learned after surgery with the assistance of your speech therapist: speech with a voice prosthesis (tracheoesophageal speech), using an electrolarynx and oesophageal speech.
The function of your nose
Your nose functions more than just smell – it heats, humidifies, and filters the air you breathe. In this way, it is ensured that the air is at the right body temperature and contains enough moisture when it reaches your lungs for it to function as it should.
After your total laryngectomy, you will breathe via the stoma in your neck so these nasal functions are lost. Breathing through an open stoma makes the temperature and humidity in your lungs drop. The lungs respond to this by producing more mucus, which means you have to cough more (similar to having a cold) and your windpipe can feel irritated.
Heat and Moisture Exchangers (HMEs) have been developed to compensate for the tasks of your nose. They help to rebalance the “climate” in your lungs.
As with any procedure, there are risks involved in laryngectomy:
• Bleeding, including hematoma.
• Salivary fistula
• Blood clots
The recovery course will rely on the extent of the surgery and reconstruction. With some surgical procedures, you could go home after a few hours of observation in the recovery room while some others might require a stay in the hospital for one to two weeks. A stay longer than two weeks is normally due to some sort of post-operative complication that your doctors are working to improve.
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