TOTAL LARYNGECTOMY

Course overview

THE PRIMARY GOAL IN TREATING LARYNGEAL MALIGNANCY IS ONCOLOGIC CONTROL OF THE DISEASE. SECONDARY GOALS INCLUDE PRESERVING SPEECH AND SWALLOWING FUNCTIONS AND AVOIDANCE OF TRACHEOSTOMY. TREATMENT REGIMENS FOR LARYNGEAL CARCINOMAS MAY INCLUDE RADIOTHERAPY, CHEMOTHERAPY, SURGERY, OR A COMBINATION. TREATMENT IS BASED ON THE TUMOR TYPE, LOCATION, FUNCTION OF THE LARYNX, AND MEDICAL AND SOCIAL COMORBIDITIES OF THE INDIVIDUAL PATIENT. TOTAL LARYNGECTOMY IS THE STANDARD OF CARE FOR SURGICAL SALVAGE IN LARYNGEAL CANCER THAT HAS FAILED OR RECURRED AFTER NONSURGICAL MANAGEMENT; IT IS ALSO PERFORMED ROUTINELY AS A PRIMARY TREATMENT FOR ADVANCED-STAGE LARYNGEAL MALIGNANCY. WHILE THE FOCUS OF TREATMENT FOR MALIGNANT LARYNGEAL TUMORS IS SHIFTING TO ONE OF ORGAN PRESERVATION, TOTAL LARYNGECTOMY REMAINS A FIRST-LINE THERAPEUTIC OPTION FOR PATIENTS WHO ARE UNSUITABLE FOR ORGAN-PRESERVING TECHNIQUES. THIS ACTIVITY REVIEWS THE ANATOMY AND FUNCTION OF THE LARYNX AND THE INDICATIONS, CONTRAINDICATIONS, AND COMPLICATIONS OF TOTAL LARYNGECTOMY. THIS ACTIVITY ALSO DESCRIBES THE TECHNIQUE OF TOTAL LARYNGECTOMY AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL HEALTHCARE TEAM IN PROVIDING OPTIMUM CARE TO PATIENTS UNDERGOING THIS PROCEDURE.