laryngectomyLaryngectomy is surgery to remove the larynx (voice box side). It is generally carried out in the treatment of laryngeal cancer . Also, the indication may be damaged due to laryngeal serious injury.

This department of the respiratory system is involved in vital processes such as breathing, swallowing and speech formation. The larynx is located in front of the esophagus and trachea. Its structure comprises the vocal cords, which prevent food from entering the lungs and vibrate, creating sounds.

You need a modern hi-tech treatment? Medical service «Tlv.Hospital» - offers diagnosis and treatment organization in Israel:

  • selection of the best doctors and medical institutions, taking into account individual wishes;
  • organizing and conducting examinations and treatment in the shortest possible time;
  • comfortable stay in the country;
  • clock support;
  • solid and transparent prices.

The surgical procedure depends on the degree of malignancy. The total operation involves complete removal of the larynx when the tumor has grown into the surrounding tissue, e.g., lymph nodes, usually a 3 - stage 4 cancer. As a result of surgery he loses his voice in the conventional sense, and can not breathe through the natural way, so apply tracheostomy tube (on the neck hole).

When performed new formation of small partial removal of the larynx, in most cases, a vocal cord. This operation allows you to keep the possibility of swallowing and certain functions of speech. It can perform endoscopic and open way. Partial laryngectomy mostly combined with radiotherapy or chemotherapy. Also perform other types of surgical intervention for laryngeal cancer.

Laryngeal cancer - a disease with a great chance of cure. Earlier treatment increases the possibility of recovery. The initial step is treated using methods that preserve the function of the larynx.

The consequences of the removal of the larynx

When planning the operation to be aware of possible complications. These include infection, bleeding, excessive swelling, shortness of breath, blood clots, Athos (inability to colloquially), damage to the esophagus or trachea, recurrent disease.

Noted factors that may increase the risk of complications of obesity, smoking and pre-existing disease, advanced age, prior to this operation in the area of the larynx, malnutrition, diabetes , radiation and chemotherapy. Before laryngectomy these risks are discussed with a doctor.

The cost of surgery to remove the larynx in Israeli hospitals from 15 000 $.

Preparation for surgery to remove the larynx

Surgical intervention is preceded by a complex of diagnostic measures in Israel: examination of the larynx, biopsy sampling for accurate diagnosis, laryngoscopy, laboratory tests (blood, urine), chest X-ray, ECG, in some cases, CT or PET-CT for prevalence studies of malignant process.

In case of total laryngectomy to consult with a specialist in speech pathology.surgery to remove the larynx

Before the surgery, a doctor explains how to restore speech in the future.

Anesthesia

During surgery to remove the larynx in Israel used general anesthesia, anesthetic is administered through a drip in the arm or hand.

The course of surgery to remove the larynx in Israel

When total laryngectomy surgeon performs an incision in the neck, it separates the muscles attached to the roof. The operation will remove the larynx and surrounding tissue.

Cancer partial laryngectomy operations efficiency is very high, over 90% of patients are cured.

The neck opening or stoma created, which are attached to the trachea, allowing the patient to breathe. Sometimes for the same purpose, use the tracheostomy tube inserted in the hole. The surgeon sets the drainage pipe, the outlet fluid and blood. At the end of the operation the skin and muscles are sutured or staples. Surgery to remove the larynx may last about 5-9 hours. hospitalization period is 7-14 days.

In case of partial laryngectomy the early stages of cancer of the larynx, the surgeon carries out removal of the tumor with a portion of the larynx via the open or endoscopic surgery.

  1. The endoscopic method (through the mouth), treatment of laryngeal cancer is the most frequently used, is performed poluambulatorno, hospitalization is one day. Operation requires modern equipment (microscope, surgical laser) technology, experience and qualifications of doctors, which undoubtedly provide Israel Hospital. The main goal is to complete removal of the tumor. Patients tolerate partial laryngectomy endoscopically fairly easily.
  2. Open resection performed by incision on the neck and involve imposing temporary tracheostomy within 3-5 days. Then tracheostomy was removed and the hole after 1-2 weeks on their own closed. The advantage of this operation is extremely high reliability.

The physician based diagnostic selects the most optimal way, with the ultimate goal - cure cancer and maintain respiratory function, swallowing and acceptable voice quality. Some degree of hoarseness is a consequence of surgery. It depends on many factors, for example, the size of the tumor. The greater the malignancy, the more likely a pronounced deterioration in voice communication with the removal of a large volume of tissue.

The recovery period after the removal of the larynx

laryngectomyAfter surgery, the patient in Israel some time stored in the intensive care unit, where he operate intravenous infusion, heart rate monitors, blood pressure and respiration. Doctors recommend the patient to breathe deeply, cough and rotated in order to improve the discharge of the accumulated phlegm in the lungs. In order to remove accumulated fluid to a patient operate several sanations. To treat pain and provide pain medicine.

The healing process of the throat tissue lasts about 2-3 weeks. The patient takes food by nasogastric tube. Ability to speak and there is no doctor on speech pathology helps with adaptation. Air passing through a tracheal stoma, can not be humidified. Therefore, to prevent drying of the mucous membranes of the trachea, the patient is breathing humidified air. Doctors are taught how to properly care for the tracheostomy. Fully recovery period after the removal of the larynx takes approximately one month.

Most patients return to work and normal life, except for a swimming. Doctors fully consulted about showering, bathing and water impacts on the surgical site.

The total operation involves complete removal of the cancer cells. After surgery, adjuvant therapy may conduct - radiation and chemotherapy. These methods aim at destroying the possible remaining malignant cells.

A positive value is smoking cessation, which significantly reduces the risk of relapse. Hoarseness is an early sign of cancer of the larynx and requires mandatory treatment in the ENT doctor .

Restoration of voting after the removal of the larynx

One of the most serious consequences of an all-out operation is the lack of voice along with a lack of nasal breathing. The methods of voice rehabilitation are divided into three types.

1. Esophageal voice is the old-fashioned way, complex processes, creating new compensatory phonational body and changing the conditioned reflex connections in the central nervous system. Its essence is to ensure that the patient is to pronounce the word or phrase is trained to swallow air and not to breathe, as it is in normal conditions. After air "ejected" backwards into the pharynx and the esophagus, the wall of assuming the role of the vocal folds, their vibration generates voice. With patient work of oncology specialists, physical therapy, speech therapy and psychology. The advantage of this method lies in the fact that phonation requires no special tools, and hands-free. The disadvantages are quite a long training (a few months), while only 60-80% of patients take possession of them, there is a chance of developing esophageal stenosis and reflux esophagitis in connection with a possible reflux of stomach contents into the esophagus. The phrases are short, the voice - a relatively monotonous and quiet.restoration of voting after the removal of the larynx

2. The electronic larynx involves the use of voice-specific devices - laryngophone that the tray, for example, to the chin. It converts vibrations oral muscles into electrical oscillations. As a result, the voice turns monotonous, robotoobraznym, but at a certain skill is possible to achieve expression in speech and intonation. This method requires the participation of arms and training. Can be called from manufacturers such as Griffin has (USA), Servox Digital (Germany), Chronos (Russia) and others.

3. Voice prosthesis involves the creation of a shunt (holes) between the trachea and pharynx, where to install the voice prosthesis, special implant. Currently used tracheoesophageal bypass and traheoglotochnoe. Last in fact - the valve with a cross in one direction only: from the trachea to the pharynx. The mechanism is as follows: the patient inhales, tracheostomy covers finger and says. Air (from the lungs, as well as in healthy humans) is guided through the prosthesis into the pharynx, resulting in the mucosal vibrations that mimics the movement of the vocal cords. The advantages are: long sentences, a loud voice, they eventually gets emotional, easy to learn (success is achieved in 90-95% of cases). Among the shortcomings can be noted hand part, the need for nursing care, wear a prosthesis (an average service life of 6 to 18 months), which requires repeated surgical intervention.

Doctors in Israel clinics prefer and actively apply organosberegajushchih techniques in the treatment of cancer. They use the smallest possible in order to preserve to the fullest extent the function of organs that are affected by a malignant process.

Online video consultations with leading Israeli experts: about the benefits of online video consultation.