Larynx surgery: What is a partial laryngectomy?

Like many parts of the body, the larynx (or voicebox) can be struck by cancer. Having laryngeal cancer does not necessarily mean a total laryngectomy. There are many cases in which, due to its location, the tumour can be removed without having to remove the entire larynx. There are various surgical procedures, and to differentiate them from a total laryngectomy, they are called partial laryngectomies.

When is a partial laryngectomy performed?

The possibility of partial laryngectomy depends on the location and extent of the cancer. As the aim of a partial laryngectomy is to leave as much of the larynx as possible intact, and preserve as much speech as possible (as a total laryngectomy leaves patients unable to speak), it is only performed on smaller tumours. In theory, after recovery, the stoma (opening) made during the surgery should close once the breathing tube is removed, and the patient should be able to breathe via their natural airways, unlike with a total laryngectomy.

Types of partial laryngectomy

In the specialty of Otorhinolaryngology (ENT), there are various types of partial laryngectomy depending on the anatomical structures that have to be removed:

• Cordectomy: removal of the vocal cords.
• Frontolateral laryngectomy: excision of the vocal cords and the anterior third of the contralateral cord.
• Hemilaryngectomy: removal of the vocal cords, the thyroid wing and the arytenoid cartilage.
• Supraglottic laryngectomy: removal of structures between the glottis and the base of the tongue.
• Reconstructive laryngectomy (cricohyoid-epiglottopexy): removal of the glottis (vocal cords), thyroid cartilage and, optionally, the epiglottis.
• "Three quarters" laryngectomy (near total): Hemilaryngectomy in addition to supraglottic laryngectomy.

What happens after a partial laryngectomy

In the postoperative period, three important functions are distinguished:

• Breathing: Although some techniques may require a temporary tracheotomy, after all of them, except for near total laryngectomy, the patient will be able to breathe naturally.
• Swallowing: Is the most affected and most difficult function after the operation, especially in cases where the epiglottis is removed, as there is a risk of bronchoaspiration (passage of food into the respiratory tract).
• Phonation: The alteration of voice function depends on the surgery performed. The alteration of the voice is directly related to the extirpation of the vocal cords, so in a supraglottic laryngectomy, the voice is usually unchanged because the vocal cords are undamaged; with cordectomy, frontolateral laryngectomy and hemilaringectomy, the voice will be weak and breathy. Finally, in other techniques, the voice is usually heavily damaged, and speech may be difficult.

If you are concerned that you might have cancer of the throat of larynx, you should contact your doctor or a specialist.