Laryngectomy

Surgery is one of the main treatments for laryngeal cancer. The main aim of laryngectomy surgery is to remove the cancer completely.

A partial laryngectomy is surgery to remove the part of the larynx affected by cancer. This operation is rare, as people are usually offered radiotherapy or chemoradiation instead.

Some people have an operation to remove the cancer by removing the whole larynx. This is called a total laryngectomy. Your doctors may offer this treatment if they think radiotherapy may not cure the cancer completely. You may also need some lymph nodes removed from your neck (see below).

You might have a partial laryngectomy to treat early stage cancer of the larynx or if you need more treatment. Your surgeon will remove the affected part of the larynx.

This may be done endoscopically. This means the surgeon passes the instrument down the throat. Or it may be done through a cut in the neck.

After a partial laryngectomy, you still have part of your larynx. You may have some difficulties with your voice or swallowing. This will depend on the type of partial laryngectomy you have.

Your surgeon and speech and language therapist (SLT) will discuss your specific operation, how it might affect you and ways to cope.

Sometimes, surgery or radiotherapy to the larynx causes temporary swelling around the throat. This can narrow your airway and make it difficult to breathe.

If this happens, the surgeon creates a small opening at the front of the neck. This allows them to insert a tube into the windpipe (trachea) to help you breathe. This is called a tracheostomy or stoma.

The tracheostomy is held open by a small plastic tube that is a few centimetres long. The tube stays in place until the swelling improves. This usually takes a few days. After this, the tube is removed. You breathe through your nose and mouth like you did before. When the tube is removed, the opening is left to heal naturally.

If your surgeon thinks you need a tracheostomy after surgery, they will talk to you about it beforehand. You will have time to ask the specialist nurse or SLT questions before you have surgery.

We have more information about having a temporary tracheostomy.

Surgery to remove the cervical lymph nodes in one or both sides of the neck is called a neck dissection.

It tells your doctor more about the stage of the cancer, removes any lymph nodes that contain cancer cells and reduces the risk of the cancer coming back.

A neck dissection is done under general anaesthetic. It can be done:

• at the same time as the operation to remove the cancer
• before or after chemoradiation or radiotherapy if the lymph nodes still have cancer cells in them
• if the cancer comes back in the nodes after treatment.

You have tests first to see if there are any signs of cancer in the lymph nodes. The nodes that are removed are sent to a laboratory. A pathologist checks them for cancer cells. Your surgeon will talk to you about this before your operation.

After the operation, your neck and shoulder may be stiff on the side where you had the surgery. A physiotherapist can show you exercises to help with this.

We have more information about what to expect after your operation.

You may find it useful to speak to other people who have had a laryngectomy, or other surgery which has changed the way they look. These support groups may be helpful:

• Cancer Laryngectomee Trust
  The Cancer Laryngectomee Trust provides support to people who are about to have, or have had a laryngectomy.
• Changing Faces
  Changing Faces offers advice and information to anyone who is affected by a change in their appearance.
• National Association of Laryngectomee Clubs
  The National Association of Laryngectomee Clubs aims to promote the welfare of people who have had a laryngectomy, and their families.