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Head and neck cancer

Having a laryngectomy

Macmillan Cancer Support

After consent

Once you have consented for your surgery you will usually have your operation within one month.

In between that time you will have a pre-assessment to check on your general health and an opportunity to discuss your surgery with the speech therapist, dietitian and specialist nurse.

At the time of surgery

  • After your operation you will return to ward 35 and a nurse will care for you on a one to one basis for 48 hours.
  • You will have a tracheostomy tube to maintain your airway, and will be attached to some equipment that helps to give you warm, moist oxygen.
  • The nurses will give you fluids and medications through a drip.
  • You will also have a catheter inserted into your bladder in theatre to measure your urine which is usually removed approximately 48 hours later.
  • You will have some drains that collect fluid from around your wound usually for three to five days and then they are removed.

Recovery

  • In days two to seven after surgery the nurses will work with you to help get you moving independently and caring for your stoma.
  • Gradually the catheter, drains, drips and oxygen will all be removed.

Eating and drinking

  • You will not be able to eat and drink and you will be fed through a tube for approximately 7 to 10 days.
  • You will have a swallow assessment to make sure everything has healed up to allow eating and drinking to start. Sometimes this is delayed if not fully healed.
  • When allowed to eat and drink the nurses will start by giving you fluids, followed by soft diet and build up towards normal diet.

Discharge

  • Arrangements will be made for you to be discharged home once you are well and confident in caring for your stoma.
  • The ward nurses will arrange for you to visit home for a short period of time to ensure you are confident in managing at home before you are fully discharged.
  • The district nurse will be arranged to support you at home.

Long term effects of having a laryngectomy

  • Having a stoma means that you now breathe from your neck
    – There are stickers and wrist bands we can provide you with to inform other people of
    this in case of emergency.
    – The ward nurses will demonstrate how to ensure you keep your stoma clean and moist.
    – You will not be able to swim.
    – When showering you will need to use aids to protect your stoma.

  • Having a stoma means that you cannot smell
    – It is important to have a smoke alarm.
    – Being unable to smell can also cause some taste changes.

  • Lifting weights and straining can be difficult.

Communication

  • After having a laryngectomy, you will need help communicating. A speech and language therapist will discuss the options with you, this may include surgery to place a speech valve if appropriate (even with a valve you will not be able to talk immediately).
  • After your surgery people often use a white board or pen and paper to communicate, the ward also has a communication ipad with helpful apps you can borrow whilst on the ward.
  • Staff are also very good at lip reading
  • But it may take family and friends some time to get used to this.

Follow up:

  • After your discharge from ward 35 you will come back to ENT outpatients for your follow up two to three weeks later.
  • If you need any further treatment this will be explained to you.
  • You will have regular appointments for many years.
  • The head and neck specialist nurses or ward 35 staff can be contacted for over the phone advice.

Patient experience

South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.

This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.

To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.

T: 01642 835964
E: [email protected]

The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW.
Telephone: 01642 850850
ST1354