Laryngectomy with Neck Dissection

 

Laryngectomy is a type of surgery where the larynx, or entire voice box is removed to treat cancer. The anatomy of the voice box can get complicated for doctors and professionals if they do not deal with this area for surgery so it is always important to consult a specialist. It is located in the middle of the neck, partly protected by the thyroid cartilage, you can feel this externally as your Adam’s apple.

As the name implies, the voice box has a number of functions but its main purpose is to be a conduit for air to enter your lungs. Also, the larynx works to prevent food, liquids and saliva from falling into your lungs and causing pneumonia. Finally, the larynx is responsible for creating voice. During the surgery, your vocal cords, voice box, part of the throat, and possibly your thyroid and parathyroid glands will be removed.

After the surgery, you will not be able to speak, this is normal and you should not be alarmed. The surgery typically takes between 4-12 hours, it is considered a high risk surgery, hence the duration. The surgery may first begin by observing the throat, windpipe and esophagus with a hollow tube to evaluate the size and location of the cancer before incisions.

You will have a permanent breathing hole in the neck called a “stoma” and will no longer breathe by mouth or nose. Your sense of smell and taste will change permanently because of this and you may need to wear a tube in the neck to assist in breathing. At first you will not be able to swallow by mouth as your new throat is recuperating. For the meantime, you will have a tube that passes from your nose into your stomach through which food will be delivered. Patients typically stay in the hospital for 1-2 weeks after surgery to fully recover.

Laryngectomy is often performed with the surgery known as a “neck dissection” where lymph nodes in the neck are removed. This is performed to eradicate tissue where cancer has spread. If the cancer has appeared in your tongue, esophagus, or other parts of your throat, these may need to be removed as well.

Skin and muscle taken from your shoulder, chest or arm may be transferred to your neck to restore your throat after surgery. This is performed by another surgeon who reconstructs your throat.

As with all surgeries there are risks, these include but are not limited to:

  • Recurrence or regrowth of cancer that may need to be treated with surgery chemotherapy or radiation
  • Development of blood clots in the lungs or legs requiring medication
  • Bleeding in the neck requiring additional surgery
  • Risks of being under general anesthesia for long amounts of time including heart attack, stroke, and death
  • Damage to mouth, teeth, and tongue
  • Low thyroid hormone and low calcium requiring medication taken daily
  • Infection that may require antibiotics or additional surgery
  • Difficulty moving the tongue causing speech or swallowing problems
  • Difficulty raising the shoulder that requires physical therapy
  • Difficulty swallowing requiring additional procedures or prolonged use of a tube that enters the stomach

 Dr. Kanwar Kelley is located at Orinda California and if you need Laryngectomy with Neck Dissection, don’t hesitate to make an appointment (925) 254-6710. He is an experienced physician in many illnesses who can guide your health in the right direction.

 

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