Concept

Laryngectomy

Summary
Laryngectomy is the removal of the larynx and separation of the airway from the mouth, nose and esophagus. In a total laryngectomy, the entire larynx is removed (including the vocal folds, hyoid bone, epiglottis, thyroid and cricoid cartilage and a few tracheal cartilage rings). In a partial laryngectomy, only a portion of the larynx is removed. Following the procedure, the person breathes through an opening in the neck known as a stoma. This procedure is usually performed by an ENT surgeon in cases of laryngeal cancer. Many cases of laryngeal cancer are treated with more conservative methods (surgeries through the mouth, radiation and/or chemotherapy). A laryngectomy is performed when these treatments fail to conserve the larynx or when the cancer has progressed such that normal functioning would be prevented. Laryngectomies are also performed on individuals with other types of head and neck cancer. Post-laryngectomy rehabilitation includes voice restoration, oral feeding and more recently, smell and taste rehabilitation. An individual's quality of life can be affected post-surgery. The first total laryngectomy was performed in 1873 by Theodor Billroth. The patient was a 36 year old man with a subglottic squamous cell carcinoma. On November 27, 1873 Billroth performed a partial laryngectomy. Subsequent laryngoscopic examination in mid-December 1873 found tumor recurrence. On December 31, 1873 Billroth performed the first total laryngectomy. The patient recovered, and an artificial larynx was manufactured for him which enabled the patient to speak despite the removal of his vocal cords. Older references credit a Patrick Watson of Edinburgh with the first laryngectomy in 1866, but this patient's larynx was only excised after death. The first artificial larynx was constructed by Johann Nepomuk Czermak in 1869. Vincenz Czerny developed an artificial larynx which he tested in dogs in 1870. According to the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, there were 177,422 new cases of laryngeal cancer worldwide in 2018 (1.
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