During the surgery, the voice box known as the ‘larynx’ is taken out. After a laryngectomy, breathing happens via an opening in the neck instead of the nose and mouth.
Over 100,000 people worldwide are currently living with a laryngectomy and with today’s medical advances it is possible to return to a good life. Undergoing a total laryngectomy can be an overwhelming experience, but we want you to know that you are not alone.
It is a life-changing event, but it is possible to enjoy life again after a total laryngectomy. Coughing can be reduced to a minimum, you can learn to speak again and it is possible to enjoy scents and flavours again.
A laryngectomy does not come without consequences, and the voice box plays several important roles within the body, not just talking. It houses the vocal folds that make our voice sound. The larynx also helps us breathe and swallow. Therefore, removal of the voice box not only leads to changes in the voice, but also changes in for example breathing, swallowing, and smelling.
There are many things possible to people who have had a laryngectomy such as hands-free speech, returning to being physically active through sports and regaining a good social life.
The larynx plays several important roles. It houses the vocal folds that make our voice sound. The larynx also helps us to breathe and swallow. Therefore, removal of the voice box not only leads to changes in the voice, but also changes in breathing, swallowing, and smelling.
Another big change is the loss of nasal function. This means you will have to adjust to a different way of breathing because you can’t use your nose any more. You may not realise it, but your nose does more than just smell – it heats, humidifies, and filters the air you breathe.
It plays a huge role in keeping your lungs healthy and working well. You nose helps to make sure the air is at the right body temperature and contains enough moisture when it reaches your lungs for them to function properly. After your total laryngectomy, you will breathe through the stoma in your neck so these nasal functions are lost.
Breathing through an open stoma causes the temperature and humidity in your lungs to drop. The lungs react to this by producing more mucus, meaning you have to cough more (like you have a cold) and your windpipe can feel irritated. Luckily, Heat and Moisture Exchangers (HMEs) have been designed to help your lungs by conditioning the air you breathe in and in this way do what the upper airways used to do. They help to re-balance the “climate” in your lungs.
Our voice expresses our thoughts and feelings. In fact, it is a large part of our identity. Losing your natural voice can have a large impact on your ability to communicate. The good news is that there are several new ways of making a voice again. After the operation you will most likely work with your Speech Language Therapist (SLT) to learn to speak again.
There are basically three voicing methods that can be learned after surgery: oesophageal voice, electrolarynx, and tracheoesophageal voice (TE speech).
tracheoesophageal speech is the most common speaking method and considered to be the most successful. It creates the most natural sounding, fluent and easiest to understand kind of voice. In order to achieve TE speech, a voice prosthesis is placed in a small opening between your windpipe and food tube. The technique is usually learnt quickly and easily with help of the SLT.
You may also be given an electronic device called an electrolarynx. That is a device you place on your neck and when you press a button it generates an electronic sound that serves as your voice.
Finally, you may also learn oesophageal speech. This kind of speech requires that you swallow small amounts of air from your mouth into your food tube and “belch” the air up.
After the operation you will most likely work with your Speech Language Therapist to learn to speak and breath comfortably again.
The other important function of your nose is that it allows you to smell. After the operation you do not breathe in via the nose, so you will not smell automatically as you did before. Enjoying flavours is an important part of having a meal. Your food will taste differently without the air coming through your nose with the added scents.
Tasting food and smelling fragrances is something you can learn again, it is just a matter of technique. Basically, it is like yawning with your mouth closed. The technique is called a ‘polite yawn’, you can learn to use this special technique to get air into your nose and smell.
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