Survivorship: Life After Laryngectomy

What is a laryngectomy?

A laryngectomy is a surgery to remove the larynx. A person who has a laryngectomy is sometimes called a “laryngectomee”. Your larynx is your "voice box" or vocal cords, and they vibrate as air passes over them when you breathe out (exhale). This vibration makes sound, which is made into speech by the movement of your mouth. If the larynx is removed, speech sounds cannot be made. A “partial laryngectomy” is when part of your larynx is removed. You may be able to speak after a partial laryngectomy but your speech will probably be different than before, and it may be harder for people to understand you. The trachea (breathing tube) is redirected to an opening in your neck when your larynx is removed, resulting in a stoma (hole) in the neck that you will now breathe through. A person who has this is referred to as a "neck breather." These changes cause both safety and practical concerns.

Safety Concerns 

• Before an emergency happens, tell your local 911 and EMS that you had a laryngectomy so that they will respond if you call and do not speak.
• Get a medical alert bracelet that states you are a "neck breather." This is important because CPR breathing, or oxygen given through your mouth, won’t work.
• Carry something that can be used as an alarm in an emergency when you would otherwise yell for help. For example, an alarm on a key chain or a bell you can use to call attention to yourself.
• If you cannot speak or your speech is hard to understand, carry paper and a pen to write messages.
• The air you breathe is not going through your nose, so you will not be able to smell as well as you used to. This can cause safety issues. For example, you may not smell smoke from a fire, natural gas, or food that has gone bad. Make sure you have working smoke detectors and change the batteries every 6 months.

Practical Concerns

• Showering: It is important that you do not get water in your stoma. To keep water out you can use foam filters, stoma covers, or something else to cover it like a washcloth or baby bib. Many laryngectomees get comfortable with showering over time and don’t need anything to cover the stoma.
• Clean Air: The air going into your stoma when you breathe goes right to your lungs. Be careful around dust, pet hair, aerosol sprays, or anything that is in the air and could be inhaled. You may want to use a stoma cover for activities where the risk of inhaling something is higher.
• Humidification: Before surgery, the air you were breathing was humidified by your nose and mouth. After surgery, you no longer have this built-in humidifier. The dry air leads to more 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. Some ways to do this are to use a cool-mist humidifier when sleeping, saline squirts, and stoma covers. You can learn more about humidification from your healthcare team or at the resources below.

Speech & Swallowing

You may have trouble with speech and swallowing right away or later in life after having a laryngectomy. If you have trouble swallowing at any time, tell your healthcare team. A speech-language pathologist (SLP) can teach you about tools and techniques to help with your speech. You can work with a SLP at any time for new concerns or to talk about new technologies for speech.

Resources

Your healthcare team is always there to support you and answer questions.  For practical tips from other survivors, check out these resources:

Web Whispers: Throat Cancer and Laryngectomee Rehabilitation - Offers advice, tips, and education from survivors.

Support for People with Oral Head & Neck Cancer (SPOHNC): Provides support groups, buddy programs, education, and awareness.