Total laryngectomy basics

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 (called a stoma) instead of the nose and mouth.

Undergoing a total laryngectomy can be an overwhelming experience, but you are not alone. There are more than 100,000 people worldwide that have undergone the same operation and have proven that it is possible to maintain a good quality of life.

The changes

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. 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-language pathologist (clinician): speech with a voice prosthesis (called tracheoesophageal speech), using an electrolarynx  and esophageal speech.

The functions 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 resulting in the loss of nasal functions. 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 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 can help to rebalance the “climate” in your lungs.

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


Smelling after laryngectomy 

The other important function of your nose is that it allows you to smell. After the operation, you do not breathe in via the nose, so you will not smell automatically as you did before. Instead, you can learn to use a special technique called the NAIM (Nasal Airflow Inducing Maneuver) to get air into your nose and smell.


The freedom of hands-free speech

During the past few years, one of the key areas of development has been hands-free speech. Special devices and attachments have been developed that make it possible to use the voice prosthesis without having to occlude the stoma by hand.