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The laryngectomy patient

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Rinki Varindani
Rinki Varindani

Rinki Varindani, a speech language pathologist, presented an introduction and in-service about laryngectomy patients. The larynx or voice box is located in the neck and contains vocal cords for speaking. Cancer of the larynx is often caused by smoking and drinking and can spread through the body. Treatment options include radiation, chemotherapy, surgery, or a combination. A total laryngectomy involves complete removal of the larynx and redirection of the trachea, leaving a permanent opening called a stoma. After laryngectomy, patients can no longer speak normally and must adjust to breathing through the stoma and other changes to swallowing, smell, and taste. Proper care of the stoma is important for prevention

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The Laryngectomy Patient An Introduction and In-service PRESENTED BY: RINKI VARINDANI, M.S.,CCC-SLP SPEECH LANGUAGE PATHOLOGIST SELECT SPECIALTY HOSPITAL, SOUTH DALLAS
The Larynx (Voice Box)  The Larynx (voice box) is in the neck at the upper end of the trachea  Two bands of muscles called „vocal cords‟ for speaking  Prevents food/liquids from entering the airway  Most important for breathing, speaking, swallowing
Cancer of the Larynx  Occurs when malignant cells enter the larynx  May be caused by excessive smoking, heavy drinking,     exposure to HPV or other causes. May spread to adjacent structures, by metastasis to cervical lymph nodes, or more distantly to other parts via blood stream. Distant metastases to lungs and liver most common. 90%-95% are squamous cell carcinomas. About 60,000 laryngectomees in the U.S today
Treatment of Cancer of the Larynx Treatment options differ based on many factors and include the following options:     Radiation Chemotherapy Combination Palliative  Surgery/Laryngectomy   Partial: Removal of the part of the larynx harboring the tumor Total: Removal of the entire larynx and some adjacent tissues
Total Laryngectomy  Complex surgery involving complete     removal of the larynx & redirection of the trachea / windpipe. Permanent opening called “stoma” created at the front base of the neck. Nose & mouth no longer connected to the trachea. Air passes in and out of the lungs through the stoma/ „neck breather‟ Stoma is permanent. Will not be reversed or closed.
Before and After Total Laryngectomy
Tracheostomy v/s Laryngectomy
Tracheostomy v/s Laryngectomy Tracheostomy A hole is created into the trachea through an incision through the neck Laryngectomy Complete removal of the larynx with redirection of trachea Mainly used to treat airway obstruction. Used to treat cancer of the larynx. Person can breathe via nose/mouth Person now breathes through a „stoma‟ Speech through speaking valve. Normal sounding. No changes in voice. Speech is never „normal‟ again. Possible through TEP or electrolarynx. Changes are usually temporary. Changes are permanent & irreversible.
Changes After Laryngectomy  The trachea opens at the stoma. Patients can no longer cough     up mucous into their mouth or blow their nose. They cough up mucous through the stoma in their neck. The inhaled air no longer gets humidified by passing through the nose & mouth. The surgery takes away the epiglottis, the hyoid bone and the esophagus is reconstructed. Increased pressure generation, decreased saliva production, no peristalsis during swallow. Sense of smell & taste affected as air bypasses the nose. The person will never longer speak normally again.  All these changes affect the patient‟s overall quality of life.
Speech After Laryngectomy
Patient Safety and Care  Skin around the stoma should be cleaned at least twice a day to prevent odor, irritation and infection.  If skin becomes red or irritated, best to leave it uncovered and not expose it to any solvents for at least 2 days for it to heal.  Ensure NO WATER enters the stoma, while bathing, showering or shaving the patient. VERY DANGEROUS!  Avoid thin paper towels & tissues. Use a cloth towel.  Avoid spraying of anything directly into the stoma.  Saline bullets/sprays into the stoma to keep it hydrated 2-3x/day.  Ensure the patient has time to perform activities. Be alert!!!
Life after Laryngectomy can be FUN!
Thank you for listening!

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The laryngectomy patient

  • 1. The Laryngectomy Patient An Introduction and In-service PRESENTED BY: RINKI VARINDANI, M.S.,CCC-SLP SPEECH LANGUAGE PATHOLOGIST SELECT SPECIALTY HOSPITAL, SOUTH DALLAS
  • 2. The Larynx (Voice Box)  The Larynx (voice box) is in the neck at the upper end of the trachea  Two bands of muscles called „vocal cords‟ for speaking  Prevents food/liquids from entering the airway  Most important for breathing, speaking, swallowing
  • 3. Cancer of the Larynx  Occurs when malignant cells enter the larynx  May be caused by excessive smoking, heavy drinking,     exposure to HPV or other causes. May spread to adjacent structures, by metastasis to cervical lymph nodes, or more distantly to other parts via blood stream. Distant metastases to lungs and liver most common. 90%-95% are squamous cell carcinomas. About 60,000 laryngectomees in the U.S today
  • 4. Treatment of Cancer of the Larynx Treatment options differ based on many factors and include the following options:     Radiation Chemotherapy Combination Palliative  Surgery/Laryngectomy   Partial: Removal of the part of the larynx harboring the tumor Total: Removal of the entire larynx and some adjacent tissues
  • 5. Total Laryngectomy  Complex surgery involving complete     removal of the larynx & redirection of the trachea / windpipe. Permanent opening called “stoma” created at the front base of the neck. Nose & mouth no longer connected to the trachea. Air passes in and out of the lungs through the stoma/ „neck breather‟ Stoma is permanent. Will not be reversed or closed.
  • 6. Before and After Total Laryngectomy
  • 8. Tracheostomy v/s Laryngectomy Tracheostomy A hole is created into the trachea through an incision through the neck Laryngectomy Complete removal of the larynx with redirection of trachea Mainly used to treat airway obstruction. Used to treat cancer of the larynx. Person can breathe via nose/mouth Person now breathes through a „stoma‟ Speech through speaking valve. Normal sounding. No changes in voice. Speech is never „normal‟ again. Possible through TEP or electrolarynx. Changes are usually temporary. Changes are permanent & irreversible.
  • 9. Changes After Laryngectomy  The trachea opens at the stoma. Patients can no longer cough     up mucous into their mouth or blow their nose. They cough up mucous through the stoma in their neck. The inhaled air no longer gets humidified by passing through the nose & mouth. The surgery takes away the epiglottis, the hyoid bone and the esophagus is reconstructed. Increased pressure generation, decreased saliva production, no peristalsis during swallow. Sense of smell & taste affected as air bypasses the nose. The person will never longer speak normally again.  All these changes affect the patient‟s overall quality of life.
  • 11. Patient Safety and Care  Skin around the stoma should be cleaned at least twice a day to prevent odor, irritation and infection.  If skin becomes red or irritated, best to leave it uncovered and not expose it to any solvents for at least 2 days for it to heal.  Ensure NO WATER enters the stoma, while bathing, showering or shaving the patient. VERY DANGEROUS!  Avoid thin paper towels & tissues. Use a cloth towel.  Avoid spraying of anything directly into the stoma.  Saline bullets/sprays into the stoma to keep it hydrated 2-3x/day.  Ensure the patient has time to perform activities. Be alert!!!
  • 12. Life after Laryngectomy can be FUN!
  • 13. Thank you for listening!