Laryngectomy surgery is the removal of the voice box. In most cases, this procedure is performed to remove cancer. Depending on the extent of the cancer, other areas may need to be removed at the same time. After all of the cancer is removed, the throat is reconstructed which may require using tissues from another part of the body.

After Laryngectomy Care

Wound Care: Please keep all incisions clean and dry. If there is any crusting or scabbing you may gently wipe it away with normal saline or hydrogen peroxide. Make sure to keep your stoma clean and free of crusting as well.

Laryngectomy Care: The following instruction will help you take care of your laryngectomy tube, your stoma (the opening in your neck), and the skin around the stoma. Follow these steps and any other directions you have received:

Cleaning Your Laryngectomy Tube and Stoma: Clean the opening of the laryngectomy tube and the skin around it at least once a day. 

Choose a clean, well-lighted space near a sink and mirror, and collect the following supplies:

• Lint-free bandages
• Cotton swabs
• Laryngectomy tube brush
• Bowl filled with equal parts of distilled water and hydrogen peroxide
• Wash your hands with soap and warm water and put on clean, disposable, powderless gloves.
• Remove the inner cannula (the tube that slides into your trach opening).
• Hold the neck plate with one hand. With the other hand, unlock the inner cannula.
• Gently remove the inner cannula.
• Clean the inner cannula.
• Soak the inner cannula in the bowl of distilled water and hydrogen peroxide.
• Clean the inner cannula with a tracheostomy/laryngectomy tube brush. Don't use a toothbrush. Rinse with distilled water.
• Put the wet inner cannula back into the outer cannula. Lock the inner cannula in place. (Note: If you have a Blomsinger laryngectomy tube (clear plastic tube) – the entire plastic tube may be removed and cleaned as above and re-inserted as you were instructed in the hospital.)
• Clean your neck plate and skin.
• Remove the soiled gauze pad from behind the neck plate. Clean the neck plate and the skin under it. Use a clean gauze pad or a cotton swab dabbed in distilled water.
• Gently pat the skin dry.
• Put a clean, pre-cut gauze pad under the neck plate.

Clearing a mucus plug: It is normal to have some mucus in your airway, but mucus can build up and thicken. If this happens, your laryngectomy tube can become plugged. Follow these steps and any other guidelines you have been given to clear your laryngectomy tube. 

Find a clean, well-lighted space near a sink and mirror, and collect the following supplies:

• Suction machine
• Clean suction catheter (tube)
• Small bowl of distilled water
• Wash your hands with soap and warm water and put on clean, disposable, powderless gloves.
• Turn on the suction machine to the pressure setting you were given.
• Attach the suction catheter to the suction machine.
• Ensure the suction is working by dipping the catheter tip into the distilled water.
• Take a few deep breaths to fill your lungs.
• Gently insert the catheter into your laryngectomy tube. While you are inserting the catheter, don't suction. Stop inserting the catheter when you start to cough.
• Apply suction. At the same time, slowly pull the catheter out of your laryngectomy tube.  Rotate the catheter as you pull it all the way out.
• Take 5 to 10 seconds to remove the catheter completely.
• If you need to suction again, relax and breathe for a few minutes, then start over.
• It may be necessary to use a saline bullet to remove a large mucous plug (the saline will break up the plug and make it easier to suction out). If this is the case, you should open a saline bullet and squirt it directly into your stoma. Have the suction in hand and after instilling the saline, suction your stoma using the above mentioned technique.
• When you are finished, turn off the suction machine.  Discard the used catheter, water and gloves.

Activity: No heavy lifting or strenuous activity. You should not lift anything greater than 10 lbs. for the first 2 weeks after surgery. At your postoperative appointment you should ask your provider when you may resume your regular activity. You may take a shower.

Diet: A specific diet will be recommended to you at the time of discharge. You may be asked to take no foods by mouth until cleared by your surgeon. If that is the case, you will be instructed to feed yourself through a feeding tube. If no diet is given, you may eat any foods that you can swallow. Please feel free to call nutritionist Mehreen Husain (917-774-7565) with any questions or concerns regarding your diet.  

Pain: No NSAIDS, Ibuprofen, Advil, Motrin, Aleve, and no herbal supplements for 10 days unless you are instructed otherwise. If you develop constipation, please take an over the counter stool softener like Colace or Senna.

Do not drive, operate dangerous machinery, or do anything dangerous if you are taking narcotic pain medication (such as oxycodone, hydrocodone, morphine, etc.) This medication affects your reflexes and responses, just like alcohol.

Call Your Head and Neck Surgeon If You Have…

1. Any concerns. We would much rather that you call your surgeon then worry at home, or get into trouble.
2. Fever over 101.5 degrees F.
3. Foul smelling discharge from your incision.
4. More than expected swelling of your neck.
5. Shortness of breath, difficulty breathing or wheezing that does not respond to breathing treatments.
6. Severe, prolonged coughing spells
7. Coughing up yellow, smelly, bloody or thick mucus.
8. Blocked laryngectomy tube that you cannot clear with suctioning.
9. Laryngectomy tube falls out and cannot be replaced.
10. Increase warmth or redness around the incision.
11. Pain that continues to increase instead of decrease.
12. Problem urinating.

If you have difficulties breathing, you need to go directly to the Emergency Room without calling.

How to Contact Your Surgeon

For non-urgent inquiries, please call the Head and Neck Oncology offices during business hours, 9am to 5pm, Monday-Friday. If you need to speak with someone after 5pm or on a weekend, call the office, and the answering service will contact the doctor on-call to call you back.

Please note, pathology results are generally not available until 7-10 business days after your procedure. Results will be discussed in the office during your post-op visit.