Can you eat with a total laryngectomy?

Reviewed on 1/13/2021
Laryngectomy is a surgical procedure for the removal of the larynx or voice box.
Laryngectomy is a surgical procedure for the removal of the larynx or voice box.
It is mainly performed to treat cancer of the larynx. The larynx contains a pair of vocal cords that help you speak. The larynx rises upward during swallowing to guard the airways and allow the passage of food into the food pipe or esophagus. Laryngectomy may be partial or total. In a partial laryngectomy, only a part of the larynx is surgically removed. Total laryngectomy involves the removal of the entire larynx. The larynx is connected to the trachea or windpipe. After the removal of the larynx, the upper end of the trachea is secured to the skin in front of the neck to aid with breathing. Thus, after a total laryngectomy, you will breathe through the opening on your neck (stoma). Your doctor will teach you how to take care of your stoma or he may refer you to speech and language therapist to help you communicate without a larynx.

Can you eat with a total laryngectomy?

Yes, you can eat after a total laryngectomy. The procedure involves removal of the larynx, but the continuity between the throat and food pipe is retained. Therefore, you can eat and swallow food normally. A tumor involving the larynx may make it difficult for you to eat properly, which will be relieved after a total laryngectomy. Right after a total laryngectomy, you will be fed through a tube (nasogastric or NG tube). The NG tube will be passed through your nose into the stomach. On the first day after the surgery, you will be given water through the NG tube, and later you will be given a liquid nutritional formula. Around 8-10 days after the surgery, you may be able to swallow liquids. This might be delayed because of generalized poor general health or if you have received radiation or chemotherapy. Once you have recovered enough to start swallowing liquids, the NG tube will be removed. You will be started with liquids and gradually moved from semisolid or pureed foods to solid foods. Your doctor will help you choose the right type of food for eating till you can be shifted to your regular diet. Initially, you may have some discomfort while swallowing or a sensation that the food is sticking to your throat. You may need some training to swallow after the procedure. You must sit upright when you eat so that food travels into the esophagus with ease because of the effect of gravity. It is important to take small sips or bites while you eat or drink. You must ensure that you have swallowed all the food you have taken into your mouth before you take another bite. Sipping water or other fluids between each bite may help in swallowing.

What are the complications of a total laryngectomy?

The complications of a total laryngectomy may include:

  • Bleeding
  • Wound infection
  • Hematoma (collection of blood in the tissues)
  • Seroma (a lump formed by the collection of clear fluid in the tissues)
  • Pharyngocutaneous fistula (an abnormal pathway between the throat and skin)
  • Stomal stenosis (abnormal narrowing of the stoma causing breathing difficulty)

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References
https://emedicine.medscape.com/article/2051731-overview

https://www.cancer.org/cancer/laryngeal-and-hypopharyngeal-cancer/treating/surgery.html

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