The surgery to remove vocal cords is called a laryngectomy.
A laryngectomy is a surgical procedure that involves the removal of all or part of the larynx, commonly known as the voice box. Since the vocal cords are located within the larynx, their removal is an integral part of this operation, especially in cases of total laryngectomy.
Why is a Laryngectomy Performed?
This significant surgery is primarily performed to treat conditions that severely affect the larynx and its crucial functions. The most common reasons include:
- Laryngeal Cancer: This is the leading cause, especially when the cancer is advanced or has not responded to other treatments like radiation or chemotherapy.
- Severe Trauma: Accidents or injuries that cause irreversible damage to the larynx, making it impossible for the patient to breathe or swallow safely.
- Radiation Necrosis: Damage to the laryngeal tissue resulting from previous radiation therapy, leading to chronic pain, infection, or breathing difficulties.
- Severe Aspiration: Inability to protect the airway, leading to food or liquids entering the lungs, which can cause recurrent pneumonia.
Types of Laryngectomy
The specific type of laryngectomy performed depends on the extent of the disease or damage. This can range from removing only a portion of the larynx to the entire structure.
| Type of Laryngectomy | Description | Vocal Cord Involvement | Impact on Voice |
|---|---|---|---|
| Partial Laryngectomy | Removal of only a portion of the larynx. This may include removing one vocal cord or a part of the vocal box, aiming to preserve some vocal function. | One or both vocal cords may be partially or completely removed, depending on the extent of the surgery. | Often altered but potentially preserved to some degree. |
| Total Laryngectomy | Removal of the entire larynx, including the vocal cords, epiglottis, and surrounding cartilages. A permanent opening (stoma) is created in the neck for breathing. | All vocal cords are removed. | Natural voice is permanently lost. |
For the specific question of removing vocal cords, a total laryngectomy guarantees their complete removal as they are an integral part of the larynx.
Impact on Speech and Voice
The removal of vocal cords, particularly in a total laryngectomy, means the natural ability to produce voice is lost. However, significant advancements in rehabilitation have provided patients with various methods to regain communication:
- Esophageal Speech: Patients learn to swallow air into the esophagus and release it to produce vibrations, forming words.
- Tracheoesophageal Puncture (TEP) with Voice Prosthesis: A small surgical puncture is made between the trachea and esophagus, and a one-way valve (voice prosthesis) is inserted. Air is directed from the lungs through the prosthesis into the esophagus, producing vibrations for speech. This is currently one of the most common and effective methods.
- Electrolarynx: An external device held against the neck that produces vibrations, which are then articulated into speech by the mouth and tongue.
Post-Operative Considerations
Patients undergoing a total laryngectomy will have a permanent stoma (an opening) in their neck through which they breathe. This requires ongoing care, including humidification of the air and protection from foreign particles. Swallowing function is typically preserved, as the esophagus is separate from the reconstructed airway. Rehabilitation often involves speech therapists, social workers, and support groups to help patients adapt to these life changes.
