What is a total laryngectomy?
5 minute read | Published March 20, 2025
Medically Reviewed | Last reviewed by Eduardo Diaz Jr., M.D., on March 20, 2025
A total laryngectomy is the surgical removal of the larynx, or voice box. It is a common procedure used to treat laryngeal cancer.
But how long does it take to recover from a total laryngectomy fully? And, will you be able to speak, swallow and eat normally afterward?
Read on, for answers to these questions and more.
What is a larynx?
Your larynx is the valve at the top of your windpipe. It closes to let you swallow and opens to let you breathe. When air passes through it, it generates sound that you can use to produce speech with your teeth, tongue and lips.
Why might you need a laryngectomy?
The larynx has to be removed when it is not working properly. Usually, this is due to laryngeal cancer. But sometimes, we do this even after someone has completed cancer treatment.
In rare cases, for instance, a patient may not have cancer any longer, but the treatment for it caused the larynx to stop working correctly, and as a result, the patient cannot eat. In those situations, a total laryngectomy might be called for.
This type of situation is very rare, but persistent smokers are the most at risk.
Are there different types of laryngectomies?
Yes. The entire larynx is removed during a total laryngectomy. Only a part of it is removed during a partial laryngectomy.
After a total laryngectomy, there is no way to keep food from getting into the airway. So, we bring the trachea (or windpipe) up to the skin and close it off from the throat. That way, anything swallowed will only go to the esophagus. Patients then breathe through a stoma, or surgically created hole, in their neck.
If only a part of the valve is affected, and we can preserve enough function, we may do a partial laryngectomy. There are several procedures available in which we can take out and reconstruct the valve, or use a laser to destroy the cancer. This allows many patients to avoid a permanent stoma.
Which patients make the best candidates for a total laryngectomy?
Total laryngectomies are used primarily when laryngeal cancer recurs. If you’ve never been treated for laryngeal cancer before, we have many other options to try first. But it doesn’t necessarily have to be a big tumor to require a total laryngectomy; it just has to be in a critical spot.
We do many more partial laryngectomies here at MD Anderson than total laryngectomies. But rehabilitation after a partial laryngectomy using open surgery can be long and hard. Only certain patients and tumors are well-suited for it.
On the other hand, if a tumor is small and easy to access, a laser procedure might be an option. These can provide excellent control and recovery is almost immediate.
What are the risks of a laryngectomy?
As with any major surgery, one of the biggest risks is infection. Fortunately, that is quite rare here at MD Anderson because of the extensive infection controls we have in place.
Another risk is delayed healing. That’s especially an issue in patients who have previously received radiation therapy to the head or neck. After the tissue has been irradiated, it sometimes doesn’t heal very well, so the incision can open back up, leak or take a long time to fully close.
Finally, since you’re no longer drawing air in through your nose to breathe after a laryngectomy, your senses of taste and smell could become blunted.
How long does it take to recover from a total laryngectomy?
You can expect to spend 5-7 days in the hospital afterward, and to wake up with one or two drains in your neck. These will be removed over the next few days.
There will also be a plastic placeholder in the stoma while it heals. And, you’ll be on a feeding tube for anywhere from five days to three weeks, depending on whether you’ve had radiation.
Can you eat normally after a total laryngectomy?
Yes. You’ll be able to eat anything you ate before the procedure. In some cases, you can even eat better. That’s because the tumor will no longer be narrowing or blocking your esophagus. Patients rarely have any significant swallowing issues after a laryngectomy.
Is there anything you can't do after a laryngectomy?
Swim. You’ll be breathing through a hole in your neck for the rest of your life. So, you won’t be able to go swimming anymore. You shouldn’t even be around deep water or in small boats because if you fall in, you will drown. You can still take showers, though.
Can laryngectomy patients speak?
Yes, though you will have to learn a new way to generate sound after a total laryngectomy. One way is with a small, hand-held device called an electrolarynx that you hold up to your throat. Another is with a tracheo-esophageal puncture (TEP), which allows you to generate sound and speak without one.
But there are many ways to communicate. The more motivated you are, the more successful you will be in finding a solution that works well for you. By working with our speech pathologists, most patients are able to regain that ability very quickly.
Why should you come to MD Anderson for a laryngectomy?
Like everything in medicine, the more you do something, the better you are at it. Our surgeons perform about 20 of these operations a month. So, we have extensive experience not only with the procedure itself, but most importantly, with the rehabilitation.
A laryngectomy is not just about the surgery. That’s actually the easy part. It’s the ancillary services here that add value more than anything else. We have entire support teams dedicated to getting patients back to talking and swallowing normally. Our speech pathologists and physical therapists are amazing.
What’s the most important thing to know about a laryngectomy?
In many cases, a total laryngectomy offers you the highest chance of a cure and the quickest way to get back on your feet.
We realize it’s a big sacrifice, though, so we don’t make the recommendation lightly. We also don’t suggest it just because we think it might help a little bit. A total laryngectomy is not an operation of last resort. The reason we do it is that it works.
The beauty of this procedure is that it is highly effective at controlling cancer and offers a very good chance of a cure. You can live a long and healthy life afterward, with very few limitations.
Eduardo Diaz Jr., M.D., is a head and neck surgeon who specializes in laryngeal cancer.
Request an appointment at MD Anderson online or call 1-844-317-6206.
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