LARYNGEAL CANCER SURGERY

What is the larynx?

The larynx, commonly known as the voice box, is an organ located above the windpipe (trachea) responsible for speech, breathing, and swallowing functions. The vocal cords are part of the larynx and are situated in the middle section. Cancers can develop in the vocal cords or in regions above and below the vocal cords. Laryngeal cancer is more commonly seen in men. Smoking increases the risk not only for lung cancer but also for laryngeal cancer.

What are the symptoms of laryngeal cancer?

Cancer in the larynx can cause various symptoms depending on the affected area. If it develops in the vocal cords, it can lead to hoarseness. If it occurs above the vocal cords, it may result in difficulty swallowing, and if it develops below the vocal cords, it can cause breathing difficulties. Cancers in the vocal cords can be detected early because they quickly affect voice quality. In cases of upper region cancers, swallowing difficulty may develop, while in lower region cancers, breathing problems may not appear until the cancer has grown and the disease has progressed. Swelling or lump in the neck, ear pain, persistent cough, and bad breath can also be symptoms of laryngeal cancer. Weight loss and symptoms related to other organs (due to cancer spreading) may occur in advanced stages.

When should I see an Ear, Nose, and Throat (ENT) specialist?

If symptoms such as hoarseness persist for more than 2-3 weeks, it is essential to consult an Ear, Nose, and Throat specialist. The diagnosis of laryngeal cancer requires an examination of the larynx with a camera. If a suspicious ulcer or lump is observed in the larynx, imaging tests such as computed tomography (CT) or magnetic resonance imaging (MRI) may be ordered. To confirm the diagnosis of an ulcer or lump in the larynx, a small piece (biopsy) must be taken from the lesion using special instruments while the patient is under general anesthesia.

What are the treatment options for laryngeal cancer?

The primary treatment options for patients diagnosed with cancer through biopsy are surgery or radiation therapy (radiotherapy). Chemotherapy can be used to support radiation therapy. Depending on the stage of laryngeal cancer, combined treatments such as postoperative radiation therapy may also be administered.

How is laryngeal cancer surgery performed?

If laryngeal cancer is in its early stages, a portion of the larynx (partial laryngectomy) is removed. Patients who undergo this procedure usually have their tracheostomy tube (a breathing tube placed in the windpipe) removed a few days after surgery. In cases of advanced-stage cancer, the entire larynx (total laryngectomy) may be removed, necessitating the permanent opening of a breathing passage (tracheostomy) into the windpipe.

Laser removal of laryngeal cancer is only applied in specific cases of laryngeal cancer surgery. Additionally, in recent years, robotic technologies have been used in selected cases of laryngeal cancer surgery.

In laryngeal cancers that have a high probability of spreading to the lymph nodes in the neck, even if they are not in advanced stages, a neck dissection surgery is performed during the same session as the laryngeal surgery. Furthermore, for patients with advanced-stage laryngeal cancer who are late in seeking treatment, a neck dissection surgery is performed during the same session as the laryngeal surgery. The tissues removed during these surgeries are sent for pathological examination.

In cases where the entire larynx is removed in patients with advanced-stage laryngeal cancer (total laryngectomy), a permanent and non-closed airway (tracheostomy) is established for breathing.

For patients who have had only a portion of their larynx removed, the tracheostomy tube, which was initially opened to ensure a safe airway, is usually closed within a few days after the surgery, allowing the patient to breathe through the nose and mouth.

Recovery, eating, and length of hospital stay after surgery vary depending on the type of laryngeal surgery performed. Patients who have had only a portion of their larynx removed may still speak, although their voice may be hoarse. Patients who have had their entire larynx removed may require therapy, prosthetics, or electronic devices to enable speech in advanced stages.