Understanding Total Laryngectomy
A total laryngectomy is a surgical procedure where the entire larynx is removed, including the vocal cords. This results in the loss of natural voice. It is usually recommended when other treatments, such as radiation and chemotherapy, have not been successful, or when the cancer is so advanced that it is the only viable option to remove the disease entirely.
The Decision-Making Process
Deciding to undergo a total laryngectomy is a significant and challenging decision. It is made collaboratively with my patients and their families, involving detailed discussions about the nature and stage of the cancer, the potential outcomes of the surgery, and the profound changes it will bring to their lives. Our goal is to provide comprehensive information and support, ensuring that while the procedure is life-changing, it is also life-saving.
The Surgery
During the surgery, which typically lasts several hours, the entire larynx is removed through an incision in the neck. The trachea (windpipe) is then brought out to the skin of the neck to create a permanent opening called a stoma. This new pathway allows the patient to breathe directly through the stoma, bypassing the mouth and nose.
The Multidisciplinary Approach to Post-Surgery Care
Life after a total laryngectomy requires significant adjustments and the support of a multidisciplinary team. Here’s how various specialists contribute to the recovery process:
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Medical and Radiation Oncologists: These specialists play a critical role in pre- and post-surgery cancer treatment. They help manage any remaining cancer cells and provide follow-up care to monitor for recurrence.
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Speech-Language Pathologists (SLPs): SLPs are essential in helping patients regain their ability to communicate. They work with patients on methods such as esophageal speech, electrolarynx devices, and tracheoesophageal puncture (TEP) speech.
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Pharmacists: They ensure that patients have the necessary medications for pain management, infection prevention, and other post-operative needs, while also managing any interactions with ongoing cancer treatments.
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Physical and Occupational Therapists (PT/OT): These therapists assist patients in regaining their physical strength and adapting to new ways of performing daily activities. They help with mobility, breathing techniques, and overall physical rehabilitation.
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Dietitians: Proper nutrition is crucial for healing and recovery. Dietitians work with patients to create meal plans that accommodate any swallowing difficulties and ensure that they receive the necessary nutrients for recovery.
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Emotional and Psychological Support: The emotional impact of a total laryngectomy cannot be understated. Psychologists, social workers, and support groups provide the necessary emotional and psychological support to help patients and their families cope with the changes.
Ongoing Care and Monitoring
After a total laryngectomy, regular follow-ups are essential to monitor for any signs of cancer recurrence and to manage any complications. As a surgeon, my commitment to my patients extends well beyond the operating room. I work closely with this multidisciplinary team to provide holistic care that addresses all aspects of recovery.
Inspirational Stories of Resilience
Over the years, I have witnessed incredible resilience in my patients. Many have gone on to lead fulfilling lives, finding new ways to communicate, embracing their altered voice, and advocating for others facing similar challenges. Their stories of courage and adaptability are a constant source of inspiration.
A total laryngectomy is more than just a surgical procedure; it is a journey of transformation. As a head and neck cancer surgeon, my role is not only to remove the cancer but also to guide my patients through the complexities of recovery and adaptation. Together with a dedicated multidisciplinary team, we navigate the path to a new normal, where the focus is on living a healthy, fulfilling life despite the challenges.
Thank you for taking the time to read about this important aspect of head and neck cancer treatment. If you or a loved one are facing such a diagnosis, please reach out for support and information. Remember, you are not alone on this journey.
Stay strong, stay hopeful.
Dr. Sokoya
