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Reasons for Procedure
- Breathing difficulties
- Excessive swelling or bleeding
- Injury to the trachea (windpipe) or esophagus
- Blood clots
- Anesthesia-related problems
- Saliva leaking out to the skin (saliva fistula)
- Inability to speak or aphonia
- Cancer occurs again
- Pre-existing medical condition
- Advanced age
- Previous surgical procedure to the larynx
- Prior radiation or chemotherapy
- Poor nutrition
What to Expect
Prior to Procedure
- Physical exam
- Laryngoscopy —the use of a long, thin, lighted tube (laryngoscope) to examine the larynx
- Radiation therapy—to treat cancer
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
- Anti-inflammatory drugs (eg, aspirin )
- Blood thinners, like clopidogrel (Plavix) or warfarin (Coumadin)
Also talk to your doctor about ways to restore speech, such as:
- Tracheoesophageal puncture
- Hand-held speech aids
- Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
Description of the Procedure
How Long Will It Take?
How Much Will It Hurt?
Average Hospital Stay
- Have an oxygen mask over the stoma.
- Be given nutrition through an IV tube in your vein or a feeding tube. A speech pathologist or doctor will assess your ability to swallow. Depending on the results, you will progress to soft foods.
- You may also need to wear boots or special socks to help prevent blood clot formation in your legs
Be instructed to:
- Use a call bell and message board to communicate.
- Keep the head of your bed raised.
- Move your legs while in bed to increase circulation.
Learn to care for your stoma and tracheostomy tube, which includes:
- Using a mist hood over the stoma
- Keeping water out of the stoma
- Covering the stoma with a shower hood when showering
- Suctioning secretions
- Have the drains removed in about five days. The stitches will be removed in about one week.
- Be sure to follow your doctor's instructions .
- For about six weeks, avoid lifting heavy objects and doing strenuous activity.
Participate in a speech rehabilitation program. You will need to learn how to speak again. The program may involve speaking by:
- Swallowing air and expelling it (esophageal speech)
- Using an electronic device (artificial larynx)
- Installing a valve in the stoma to allow air from the lungs to reach the esophagus (tracheoesophageal speech)
Call Your Doctor
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
- Pain that you cannot control with the medicines you have been given
- Cough, shortness of breath, or chest pain
- Headache, muscle aches, or dizziness
- Tracheostoma is getting smaller
- Saliva leaking through your incision
- New, unexplained symptoms
American Cancer Society http://www.cancer.org/
National Cancer Institute http://www.cancer.gov/
BC Cancer Agency http://www.bccancer.bc.ca/default.htm/
Canadian Cancer Society http://www.cancer.ca/
All about laryngeal and hypopharyngeal cancer. American Cancer Society website. Available at: http://www.cancer.org/ . Accessed September 11, 2009.
Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 16th ed. WB Saunders Co; 2001.
- Reviewer: Marcin Chwistek, MD
- Review Date: 10/2012 -
- Update Date: 10/31/2012 -
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
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