Laryngeal Cancer

Surgery

Surgery is generally used for advanced stage laryngeal cancer. Your doctor may consider removing the cancer using a robot (Transoral Robotic Surgery, or TORS). TORS may be performed by a head and neck cancer surgeon, which is carried out through the mouth without any external cuts. 

How can I prepare for the surgery?

Your doctor will explain details of the surgery, general risks and side effects of surgery. Ask your doctor if you have questions. They may recommend:

  • stopping blood thinners (e.g. aspirin) before surgery to reduce the risk of bleeding

  • special stockings to reduce the risk of blood clots

  • early mobilisation (i.e. not staying in bed) to reduce the risk of blood clots and chest infection

  • antibiotics to lower the risk of wound infection.

If you smoke, it is important that you consider stopping smoking before starting treatment to help reduce the risk of infection and help you recover after your treatment.

Surgical procedures 

The surgery options for early and advanced laryngeal cancers are:

TRANS-ORAL laser or  TRANS-ORAL robotic surgery

Some advanced laryngeal cancers can be removed without any external cuts using a robotic system or by using laser surgery.

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LARYNGECTOMY

A laryngectomy is the removal of all (total laryngectomy) or part of the larynx (partial laryngectomy).

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PARTIAL LARYNGECTOMY

Partial laryngectomy is removal of part of your larynx. The larynx is the medical name for the voice box. 

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Hypopharyngectomy

This is removal of part of the hypopharynx via an open neck approach. 

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LARYNgopharyngectomy

This is the removal of all the larynx and pharynx. It is different to laryngectomy, where only the larynx (or part of it) is removed. 

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NECK DISSECTION

This involves removal of lymph nodes from the neck. This is important even when there is no sign of cancer in the lymph nodes on the scan, because there is a risk of microscopic cancer in the lymph glands of the neck.
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reconstructive surgery 

This may be considered if a large area of tissue is removed. This may involve taking tissue from another part of the body called a free flap repair. This operation is carried out by a surgeon who specialises in reconstructive surgery, your head and neck surgeon or another surgeon.
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TRACHEOSTOMY

A tracheostomy is used to create an opening in the trachea (windpipe) in the lower neck, where a tube is inserted to allow air to flow in and out, when you breathe. This is used as swelling after major head and neck surgery may affect your ability to breathe. The tracheostomy tube is usually removed within a week of surgery once normal breathing is possible.
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Feeding tubes 

  • A gastrostomy tube (called a PEG tube) goes through the skin and the muscles of your abdominal wall into the stomach. Gastrostomy is recommended if feeding is needed for a medium to longer time (months or years).
  • A nasogastric tube goes through the nose down into the stomach. Nasogastric feeding is used for short time (days or weeks).
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Side effects of surgery

Treatment for laryngeal cancer may lead to a number of side effects . You may not experience all of the side effects. Speak with your doctor if you have any questions or concerns about treatment side effects.