Hello and thank you for choosing Stanford Health Care.
This video will help you better understand your upcoming surgical procedure. A total laryngectomy.
We will cover how this procedure can affect you, before and after surgery, and share a few care tips for after your total laryngectomy procedure.
The larynx is your voice box. There are many reasons a voice box needs to be removed. In some cases, there are additional areas around the larynx that may need to be removed or altered.
When your voice box is removed, there are some changes to your body.
The esophagus, or feeding tube, will be separate from the breathing tube, and the vocal cords will be gone.
The procedure will impact how you breathe, talk, and swallow.
Your breathing will change.
Typically, we breathe through our nose and mouth. But after surgery, you’ll now breathe through a permanent opening at the front of your neck called a stoma.
As the air goes directly into and out of the stoma, it reaches the lungs unfiltered, less humid, and cooler. Your lungs react by producing more mucus, causing you to cough more.
When you wake up from your surgery, you’ll have a tube and Heat Moisture Exchange cassette, or HME, to help filter and moisturize the air. This tube helps keep the stoma open during healing and holds the HME.
As a result, you’ll have to wipe secretions from the stoma, which may take time getting used to. You’ll also need to learn to cover your stoma when you cough, not your mouth.
You will also have talking or speech changes.
Our vocal cords allow us to create sound. They work with our tongue, teeth, and lips so we can speak.
With the removal of the voice box or vocal cords, you’ll no longer have a sound generator. You must see a speech-language pathologist to learn different ways to speak.
Now, let’s go over the changes in relation to swallowing.
After the laryngectomy, the esophagus and swallowing process remains basically intact. However, your tissue and muscles must heal before you can eat again.
So, you will have a temporary feeding tube from your nose to your stomach to provide nutrition and hydration.
Once your surgical site heals, your doctor will allow you to eat. But you may need a swallow study first to make sure you are healed.
Because of the changes to your breathing, speaking, and swallowing, there are a few recovery and care tips that you should follow. Here is what you’ll do after your total laryngectomy procedure.
First, it is important that you take care of your laryngectomy tube and heat moisture exchange cassette. Since you’ll no longer breathe through your nose or mouth, attention to your new airway is vital.
Once a day, using drinking water and the brush found in your laryngectomy kit, you’ll clean the tube. Remember to wipe off any excess moisture.
Inspect the HME filter to ensure the foam is clean. The manufacturer recommends changing the HME filter daily or as needed when wet with secretions.
Stoma care is also very important.
Before you re-insert the tube, be sure to clean the stoma and the skin around it with mild soap, water, and a clean face cloth.
Once the skin is dry, you can re-insert your tube. Do this 2-3 times a day.
Now we’ll go over suctioning
Coughing out your secretions is strongly encouraged. This process begins by suctioning the secretions out of your stoma using a suction machine. It is performed in the hospital and should not take any longer than 10 seconds.
Overtime, your body will adapt to the new airway passage so you can cough out all your secretions on your own and you will not need the suction machine in the future
Lastly, we’ll discuss how to care for your Tracheoesophageal Puncture.
If you have a Tracheoesophageal Puncture or TEP, you’ll need to clean it once a day with the included, thin blue brush. This helps ensure that the prosthesis is clear, and that air can pass through, so you are able to speak.
Your speech-language pathologist will also help you take care of your TEP prosthesis.
While in the hospital, you may have to write your needs on a white board initially, but your speech language pathologist will help you learn how to use the electro larynx and/or your TEP speech.
At home, it’s important to look out for signs of an infection. Your health care team will provide you with written instructions on what to watch out for and who to call.
Keep in mind, recovery after your procedure may vary.
However, most patients return to a normal, meaningful life after the procedure. . We will work with the patient to individualize each patient’s transition of care plan – whether that’s home or to a skilled nursing facility.
Therefore, actively participating with your care team will help allow for a successful recovery after your total laryngectomy procedure.
Our goal is to help you return home and transition back to independence. Remember to contact your care team in case you have specific questions about your surgery.
Thank you for letting us take care of you.