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Basics of total laryngectomy

A total laryngectomy is a surgery performed in the advanced stages of cancer. The procedure involves removing your voice box – also called the larynx. After a laryngectomy, breathing happens via an opening in the neck instead of the nose and mouth.

Undergoing a total laryngectomy can be an overwhelming experience, but you shouldn’t feel isolated. There are more than 100,000 people worldwide that have undergone the same operation and proven it’s possible to maintain your quality of life.

The consequences

The larynx plays several important roles. It houses the vocal folds that make our voice sound. The larynx also helps us to breathe and swallow. Therefore, removal of the voice box not only leads to changes in the voice, but also changes in breathing, swallowing, and smelling.

Your new voice

We rely on our voices to express our thoughts and feelings. Losing your natural voice can initially be quite upsetting, and have a large impact on your ability to communicate as well as your sense of identity. But the good news is that there are several ways to regain your voice.

There are basically three voicing methods that can be learned after surgery with the help of your speech therapist: speech with a voice prosthesis called tracheoesophageal speech), using an electrolarynx  and esophageal speech.

The function of your nose

Your nose does more than just smell – it heats, humidifies, and filters the air you breathe. In this way, you can be sure the air is at the right body temperature and contains enough moisture when it reaches your lungs for them to function properly.

After your total laryngectomy, you will breathe through the stoma in your neck so these nasal functions are lost. Breathing through an open stoma causes the temperature and humidity in your lungs to drop. The lungs react to this by producing more mucus, meaning you have to cough more (similar to having a cold) and your windpipe can feel irritated.

Heat and Moisture Exchangers (HMEs) have been developed to compensate for the functions of your nose. They help to rebalance the “climate” in your lungs.

Read more about what you can do to rehabilitate your lungs after a total laryngectomy.