Laryngectomy Health Article

Definition

A laryngectomy is the partial or complete surgical removal of the voice box (larynx).

Purpose

Because of its location, the voice box, or larynx, plays a critical role in breathing, swallowing, and speaking. The larynx is located above the windpipe (trachea) and in front of the food pipe (esophagus). It contains two small bands of muscle called the vocal cords that close to prevent food from entering the lungs and vibrate to produce the voice. If cancer of the larynx develops, a laryngectomy is performed to remove tumors or cancerous tissue. In rare cases, the procedure may also be performed when the larynx is badly damaged by gunshot, automobile injuries, or other traumatic accidents.

Demographics

The American Cancer Society estimates that, in 2003, about 9,500 people in the United States will be found to have laryngeal cancer. Laryngeal cancer occurs 4.4 times more frequently in men than in women, although, like lung cancer, it is becoming increasingly common in women. Tobacco smoking is by far the greatest risk factor for laryngeal cancer. Others include alcohol abuse, radiation exposure, asbestos exposure, and genetic factors. In the United Kingdom, cancer of the larynx is quite rare, affecting under 3,000 people each year.

Description

Laryngectomies may be total or partial. In a total laryngectomy, the entire larynx is removed. If the cancer has spread to other surrounding structures in the neck, such as the lymph nodes, they are removed at the same time. If the tumor is small, a partial laryngectomy is performed, by which only a part of the larynx, usually one vocal chord, is removed. Partial laryngectomies are also often performed in conjunction with other cancer treatments, such as radiation therapy or chemotherapy.

During a laryngectomy, the surgeon removes the larynx through an incision in the neck. The procedure also requires the surgeon to perform a tracheotomy, because air can no longer flow into the lungs. He makes an artificial opening called a stoma in the front of the neck. The upper portion of the trachea is brought to the stoma and secured, making a permanent alternate way for air to get to the lungs. The connection between the throat and the esophagus is not normally affected, so after healing, the person whose larynx has been removed (called a laryngectomee) can eat normally.