Laryngectomy: Before Your Surgery

What is laryngectomy?

Laryngectomy is the removal of all or part of the voice box (larynx). The voice box is in the neck and contains the vocal cords. It also helps you swallow and breathe. It is taken out to treat cancer of the larynx.

You will be asleep during the surgery. The doctor will take out all or part of the voice box through a cut in the front of your neck. This cut is called an incision. How much of the voice box the doctor takes out depends on how large the cancer is and how far it has spread. You will have stitches or staples in the incision.

Your ability to talk after surgery depends on how much of the voice box is removed. If all of it is removed, you will not be able to talk. In this case, the doctor will also create an opening in your neck to help you breathe. This is called a tracheotomy. The opening is called a stoma.

You will probably have a tube in the incision to drain fluid for a few days after surgery. The stitches or staples will be taken out 1 to 2 weeks after surgery. The scar will fade over time. For a week or more after surgery you will need to get food through a feeding tube. The feeding tube goes into your nose and down your throat to your stomach.

You will probably need to stay in the hospital for 1 to 2 weeks after surgery. Speech therapy will help you learn new ways to communicate if you can't talk normally after surgery.

Losing your ability to talk can be very upsetting and hard to accept. For some people, it can lead to depression. If you need help after surgery, you may want to see a counselor.

How do you prepare for surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

What happens on the day of surgery?

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• How long the surgery takes depends on how much of the larynx the doctor takes out.

When should you call your doctor?

• You have questions or concerns.
• You don't understand how to prepare for your surgery.
• You become ill before the surgery (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about having the surgery.