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Reasons for Procedure
- Breathing difficulties
- Excessive swelling or bleeding
- Opening of the incision or poor wound healing
- Injury to the trachea, also known as the windpipe, or esophagus
- Blood clots
- Anesthesia-related problems
- Saliva leaking out to the skin
- Inability to speak or aphonia
- Cancer occurs again
- Pre-existing medical condition
- Increased age
- Previous surgical procedure to the larynx
- Prior radiation or chemotherapy
- Poor nutrition
What to Expect
Prior to Procedure
- Physical exam
- Laryngoscopy—the use of a long, thin, lighted tube to examine the larynx
- Radiation or chemotherapy—to treat cancer
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
Also talk to your doctor about ways to restore speech, such as:
- Tracheoesophageal puncture
- Hand-held speech aids
- Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
Description of the Procedure
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- Have an oxygen mask over the stoma.
- Be given nutrition through an IV or a feeding tube. A speech pathologist or doctor will assess your ability to swallow. Depending on the results, you will progress to soft foods.
- You may need to wear boots or special socks to help prevent blood clot formation in your legs
- Learn how to:
- Use a call bell and message board to communicate.
- Keep the head of your bed raised.
- Move your legs while in bed to increase circulation.
Learn to care for your stoma and tracheostomy tube, which includes:
- Using a mist hood over the stoma
- Keeping water out of the stoma
- Covering the stoma with a shower hood when showering
- Suctioning secretions
- Have the drains removed in about 5 days. The stitches will be removed in about one week.
- Avoid lifting heavy objects and doing strenuous activity for up to 6 weeks.
Participate in a speech rehabilitation program. You will need to learn how to speak again. The program may involve speaking by:
- Swallowing air and expelling it—esophageal speech
- Using an electronic device—artificial larynx
- Installing a valve in the stoma to allow air from the lungs to reach the esophagus—tracheoesophageal speech
Call Your Doctor
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Persistent nausea and/or vomiting
- Pain that you cannot control with the medications you've been given
- Cough, shortness of breath, or chest pain
- Difficulty swallowing
- Difficulty eating
- Headache, muscle aches, or lightheadedness
- Tracheostoma is getting smaller
- Saliva is leaking through your incision
- New, unexplained symptoms
American Cancer Society http://www.cancer.org
National Cancer Institute http://www.cancer.gov
BC Cancer Agency http://www.bccancer.bc.ca
Canadian Cancer Society http://www.cancer.ca
Hanasono MM, Lin D, Wax MK, Rosenthal EL. Closure of laryngectomy defects in the age of chemoradiation therapy. Head Neck. 2012;34(4):580-588.
Laryngeal and hypopharyngeal cancers. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003108-pdf.pdf. Accessed May 23, 2014.
Laryngectomy. UC Davis Health System website. Available at: http://www.ucdmc.ucdavis.edu/otolaryngology/Health%20Information/LARYNGECTOMY.pdf. Accessed May 23, 2014.
- Reviewer: Michael Woods, MD
- Review Date: 06/2015 -
- Update Date: 00/52/2014 -