Laringektomija – Laryngectomy

Description of the removal of the larynx

Laringektomija – surgery to remove the larynx (part of the voice box). The operation is typically performed for treating cancer. Depending on the degree of cancer, It can only be removed part of the larynx.

Reasons for removal of the larynx

Laryngectomy is performed to treat cancer of the larynx. This operation can also be done to treat damage of the larynx due to trauma.

Possible complications of laryngectomy

If you plan on removing the larynx, you need to know about possible complications, which may include:

• Infection;
• Labored breathing;
• Excessive swelling or bleeding;
• Damage to the trachea or esophagus;
• Blood clots;
• Complications from anesthesia;
• Leakage of saliva through the skin (sialosyrinx);
• Failure to speaking or afonija;
• Recurrence of cancer.

Some factors, that may increase the risk of complications:

• Pre-existing diseases;
• Advanced age;
• Obesity;
• Smoking;
• Previous surgical procedure in the larynx;
• Previous radiation or chemotherapy;
• Poor diet;
• Diabetes.

We need to discuss these risks with your doctor before surgery.

How is the removal of the larynx?

Preparation for the procedure

Before the operation can be carried out:

• Inspection;
• Laryngoscopy – to study the larynx is used long, a thin tube with a light source at the end (laryngoscope);
• Radiation therapy – for treating cancer.

On the eve of the operation:

• Consult your doctor about the drugs taken. A week before surgery you may be asked to stop taking some medicines:
  • Anti-inflammatory drugs (eg, aspirin);
  • Blood thinners, such as clopidogrel (Plaviks) or warfarin;
• Besides, you need to discuss with your doctor recovery methods of speech in the future, such as:
  • Traheoэzofagealynaya puncture;
  • Arrangements for voice synthesis.
• The night before, you can have a light meal. Do not eat or drink the night before surgery.

Anesthesia

Used general anesthesia, during the procedure the patient will sleep. The anesthetic is administered through a drip in the arm or shoulder.

Procedure removal of the larynx

The doctor makes an incision in the neck skin. He then separates the muscles, which are attached to the roof. The larynx and surrounding tissue are removed.

Sometimes, a partial laryngectomy is performed. In this case, the doctor removes the tumor with a part larynx. In carrying out such an operation may retain some normal speech function and the ability to swallow.

The skin on the neck is created stoma (opening). Thereafter, joins the trachea stoma, which will allow you to breathe. In some cases, the doctor inserts a tracheostomy tube. This handset, which is inserted into the opening, and performs the function of the respiratory tract. The doctor inserts a drainage tube to drain blood and fluids. Finally, muscles and skin will be sewn or stapled staples.

How long will laryngectomy?

5-9 hours.

Laringektomija – Will it hurt?

You will have pain during recovery. The doctor will give you pain medicine.

The average time of stay in the hospital after the removal of the larynx

This operation is performed in a hospital. Usually the duration of stay of 7-14 days. The doctor can extend the period of stay, If there are complications.

Care after the removal of the larynx

Care in a hospital

During recovery in the hospital:

• By the stoma can be connected oxygen mask;
• Power is supplied through an IV or a feeding tube (enteroalimentation). The doctor will evaluate your ability to swallowing. Depending on the results, You will gradually move to soft foods;
• You may need to wear boots or special socks, to prevent the formation of blood clots in the legs;
• Follow the instructions:
  • You should use the call to a call Personnel and Writing board for dialogue;
  • If you're lying in bed, keep your head elevated;
  • Raise legs, when you are in bed, to increase blood circulation;
• We must learn to care for the stoma and tracheostomy tube:
  • Protect the stoma against foreign objects;
  • Clean the moisture in the area of ​​the stoma;
  • Close fatigue, when taking a shower;
  • Remove selection, collects in areas of fatigue;
• Drainage tubes will be removed after about five days. The sutures are removed at one week after surgery;

Home Care

When you return home, Follow these steps:, to ensure the normal recovery:

• Be sure to follow your doctor's instructions;
• For about six weeks, you need to avoid heavy lifting and strenuous activities;
• Take part in a program to restore speech. You will need to learn to speak again. The program may include the following:
  • Swallowing and breathing out air (esophageal speech), so-called ventriloquism;
  • The use of electronic devices (artificial larynx);
  • Install the valve into the hole, to allow air from the lungs to reach the esophagus (traheoezofagealnaya speech).

Fabrics throat heal 2-3 of the week. Full recovery takes about a month. You may notice a decrease in sense of taste and smell. In the future, we need to continue to use the stoma for breathing.

Most patients can return to work and normal activities, except for swimming. Ask the doctor, when it is safe to shower, bathe, or to expose the surgical site to water.

Joining a support group can help you deal with psychological problems after surgery.

Contact your doctor after removal of the larynx

After discharge from the hospital need to see a doctor, If the following symptoms:

• Signs of infection, including fever and chills;
• Redness, edema, increased pain, bleeding or discharge from the incision;
• Nausea and / or vomiting, which do not disappear after taking the prescribed medicines, and persist for more than two days after discharge from the hospital;
• Pain, which does not pass after taking pain medication appointed;
• Cough, shortness of breath or chest pain;
• Headache, muscle aches, or dizziness;
• Tracheostomy becomes smaller;
• Leakage of saliva through an incision;
• Other symptoms.