laryngectomy

Laryngectomy is a surgical procedure that removes all or part of the larynx, or voice box. It is most commonly performed for advanced laryngeal or hypopharyngeal cancer when tumor control requires removal of the larynx or when organ-preserving options are not feasible. The operation typically creates a permanent tracheostomy (stoma) in the neck to provide a new airway, while the upper digestive tract remains dedicated to swallowing.

Two main forms are recognized. Total laryngectomy removes the entire larynx and results in the loss of natural voice, with breathing exclusively through the tracheostoma. Partial, or hemilaryngectomy/supraglottic laryngectomy, removes only part of the larynx and may preserve some degree of voice and airway function, depending on the extent and location of the tumor.

Voice restoration and rehabilitation are central to postoperative care. After laryngectomy, speech is no longer produced by the vocal cords. Common methods of communication include esophageal speech (speaking by releasing air from the esophagus), a tracheoesophageal puncture with a voice prosthesis, or an externally worn electrolarynx. Speech rehabilitation is typically guided by a speech-language pathologist. Patients require ongoing stoma care and airway humidification. Swallowing is usually preserved, though initial difficulties are common, and some complications can affect healing, such as pharyngocutaneous fistula or stomal stenosis.

Indications include malignant tumors of the larynx or hypopharynx, extensive trauma, or other severe disease where laryngeal preservation is not possible. In some cases, organ-preserving treatments such as radiation or chemoradiation are pursued to avoid laryngectomy, depending on tumor stage, location, and patient factors.