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What Is a Total Laryngectomy?

A total laryngectomy is a surgery performed in the advanced stages of cancer. The procedure involves removing your voice box – also called the larynx. After a laryngectomy, breathing happens via an opening in the neck instead of the nose and mouth.

Undergoing a total laryngectomy can be an overwhelming experience, but you shouldn’t feel isolated. There are more than 100,000 people worldwide that have undergone the same operation and proven it’s possible to maintain your quality of life.

A total laryngectomy is a surgery during which the voice box, called the larynx, is taken out. After a laryngectomy, breathing happens via an opening in the neck instead of the nose and mouth.

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The consequences

The larynx plays several important roles. 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.

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.

Your new voice

We rely on our voices to express 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 and Language Therapist to learn to speak again.

There are basically three voicing methods that can be learned after surgery: oesophageal voice, electrolarynx, and tracheoesophageal voice.

The functions of your nose

Your nose does more than just smell – it heats, humidifies, and filters the air you breathe. That way, when the air reaches your lungs it has reached body temperature and contains the level of moist needed for the lungs to function properly.

After the operation, you breathe through the stoma in your neck so these functions of the nose 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. This results in you having to cough more (like you have a cold) and your windpipe can feel irritated.

Heat and Moisture Exchangers (HMEs) like the Provox Life Home HME have been developed to compensate for the functions of your nose. They help to rebalance the ‘climate’ in your lungs.

Smelling after laryngectomy 

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 as you did before. Instead, you can learn to use a special technique called the NAIM (Nasal Airflow Inducing Maneuver) to get air into your nose and smell.

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