Supraglottic laryngectomy involves the removal of part of the larynx (voice box) that is present above the vocal cords. It is one of the treatments for supraglottic cancer. The surgery removes
Structures above the vocal cords (the false vocal cords).
The epiglottis (leaf-like covering of the larynx).
The base of the tongue and some of the cartilage and bone in this area.
Supraglottic laryngectomy is one type of partial laryngectomy, in which the upper part of the larynx is removed for a tumor that does not involve the vocal cords. Due to the high risk of metastasis (spread of cancer) to the neck nodes, a supraglottic laryngectomy as the primary treatment is usually combined with neck dissection (removal of the lymph nodes and other structures such as some nerves, muscles, and blood vessels from the neck).
The patient will still have a fairly normal voice because the original vocal cords are not removed.
Possible risks and complications
- The patient may find that it is harder to swallow. They may need to learn how to swallow after the surgery.
- All surgery carries some risks, including blood clots, infections, complications from anesthesia, and pneumonia. These risks are generally low but are higher with more complicated operations such as a supraglottic laryngectomy.
- This procedure may rarely affect the throat or voice box, leading to gradual stenosis (narrowing) of the throat. Sometimes, this can affect breathing.
- Some people may need additional surgeries such as a tracheostomy (an incision in the trachea or windpipe to relieve breathing difficulty) that increases the overall complications in the patients.
- The procedure can also lead to the development of a fistula (an abnormal connecting channel between two areas that are not normally connected). Additional surgery may be needed to fix it.
- A very rare but serious complication of neck surgery is the rupture of the carotid artery (the large artery on either side of the neck).
Recovery time
- Recovery after a supraglottic laryngectomy depends on the patient’s overall health and age. At times, an extended hospital stay is needed. Often, the patient will need a feeding tube to get nutrition until the throat heals.
- The patient will be given instructions regarding how to care for their incisions and tracheostomy tube before leaving the hospital. The healthcare team may talk to the patient and their family about the need for nebulizers to humidify the air they breathe through the tracheostomy tube.
- The medical team will discuss the medications for pain, blood clots, infection, constipation prevention, and/or other conditions.
- The patient may meet with a speech-language pathologist (SLP) who will talk about communication and swallowing techniques.
The patient is advised to:
- Avoid heavy lifting and strenuous exercise for 6 weeks.
- Avoid bending and straining until it is advised by their healthcare team.
- Perform stoma and wound care as directed.
- Speak with the healthcare team about when they can shower and how to protect the stoma from getting wet or getting water in it.
- Avoid wearing tight clothing around the neck.
- Avoid exposure to second-hand smoke and people with respiratory infections.
- Avoid contact sports.
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References
Supraglottic laryngectomy: functional and oncologic results: https://pubmed.ncbi.nlm.nih.gov/8546420/
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