OncoLink Abramson Cancer Center of the University of Pennsylvania
Laryngectomy is the surgical removal of the larynx. The person who had the procedure is called a "laryngectomee." The larynx is the "voice box" or vocal cords, which vibrate as air passes over them during exhalation, and this sound is made into our speech by the parts of our mouth. If the larynx is removed, no speech sounds can be made. A partial laryngectomy may allow speech, though in many cases it will be different than the speech was before surgery and may be more difficult for people to understand. In addition, the trachea (breathing tube) is redirected with removal of the larynx, resulting in a stoma (hole) in the neck that the laryngectomee breathes through. This is referred to as a "neck breather." These changes bring about some practical and safety concerns of which you should be aware.
Notify your local 911 and EMS service of your condition so that they will respond even if you do not speak when you call.
Get a medical alert bracelet identifying you as a "neck breather." This is important because CPR breathing or oxygen given through your mouth is ineffective.
Carry something that can be used as an alarm in an emergency when you would otherwise yell for help. For example, an alarm for a keychain or bell can call attention to you.
If you cannot speak or speech is difficult to understand, carry paper and pen to write messages.
Because the air you breathe is not going through your nose, you will have decreased ability to smell, which can have safety implications. You may not smell smoke from a fire, natural gas or sour food, for example. Make sure you have working smoke detectors and change the batteries every 6 months.
Showering: need to avoid getting water in the stoma. Options to keep water out: foam filters, stoma covers, other things use to cover the stoma like a washcloth or baby bib. Many laryngectomees get comfortable with showering over time and require nothing to cover the stoma.
Clean Air: Remember that the air going into the stoma when you breathe goes directly to your lungs. Be cautious about dust, pet hair, aerosol sprays, etc. – anything that can be in the air and inhaled. You may want to use a stoma cover for certain activities where the risk of inhaling something is higher.
Humidification: Prior to surgery, the air you were breathing was humidified by your nose and mouth. After surgery, you no longer have this built in humidifier and this dry air results in increased mucus production as the lungs try to moisten the air. You will need to learn how to increase the moisture level in the air you breathe and retain this moisture. Tools to do this include using a cool-mist humidifier when sleeping, saline squirts and stoma covers. You can learn much more about humidification from your healthcare team or at the resources listed below.
Speech & Swallowing
Issues with speech and swallowing are common after laryngectomy, but these issues can arise at any point in a survivor's life. If you experience any difficulty swallowing at any time, notify your oncology team. A speech language pathologist (SLP) can help manage swallowing difficulties and help with devices and techniques to assist with your speech. SLPs can be accessed at any time in a survivor's life for new concerns or to explore newer technologies for speech.
As you recover from surgery and get back to life, you are sure to encounter situations that you weren't prepared for. Your healthcare team is there to support you and answer questions. The following resources can provide lots of practical tips from other survivors who have "been there."
Web Whispers: Throat Cancer and Laryngectomee Rehabilitation - Offers advice, tips and education from survivors.