LIFE AFTER HAVING YOUR VOICE BOX REMOVED (TOTAL LARYNGECTOMY)

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LIFE AFTER HAVING YOUR VOICE BOX REMOVED (TOTAL
LARYNGECTOMY)

• Carole Glover
• Hugh McGrath

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Why is Total Laryngectomyperformed

• Laryngeal cancer involving thyroid cartilage
• Following recurrence / failing radiotherapy

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• What are the changes and functions of the anatomy

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• Humidification
• Speech
• Swallow
• Secretions
• Loss of sense of smell
• Altered body image

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Pre operative

• CNS / Support Nurse and Speech Therapist pre op
  talk
• Meet another laryngectomy patient

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PATENCY OF STOMA

• It is essential that stoma size is maintained
  ease of airway management
• - changing of voice prosthesis (if patient
  has one)
• Lary Tubes (cleaned using normasol sachets
  trachy cleaning swabsStoma buttons)

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HUMIDIFICATION

• Due to altered anatomy patients have lost
  ability to filter, warm humidify the air they
  breathe
• Methods of humidification
• Heated humidification on the ward
• HME cassette
• Stoma protector
• Normal saline nebulisers
• Laryngofoam
• Some pts mucus

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Surgical Voice Restoration

• Use of lung air diverted through voice prosthesis
  into pharynx
• Life span of prosthesis varies
• Types of valves

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• Self changing of prosthesis
• SVR team change some prosthesis
• Candida build up leakage

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Post operative support

• Pre discharge talk
• Countrywide supplies
• Emergency information e.g. Resus
• D/N twilight visit
• Text number
• Drop in clinic

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Patient experience

• General fatigue
• Mucus difficulties
• Reduction of upper body strength following
  reconstructive surgery
• Social problems
• Day to day routine / life