Surgery for Laryngeal Cancer

Doctors may perform open surgery to remove advanced or complex tumors, which are more extensive and may affect nearby tissues and organs.

Radiation therapy uses energy beams to destroy cancer cells and is also an option for early laryngeal cancers. Radiation therapy may be given with chemotherapy, a group of drugs that make the cancer more sensitive to radiation, to manage advanced laryngeal cancer.

NYU Langone doctors assess the characteristics of the tumor to help determine the best treatment approach for you.

Minimally invasive procedures allow doctors to remove laryngeal cancer without making incisions in the neck.

Endoscopic Transoral Resection

In endoscopic transoral resection, a surgeon removes early laryngeal cancer through an endoscope—a thin, lighted tube with a lens at the tip that transmits images to a monitor. Doctors also use a microscope to get a precise view of the anatomy of the area. The procedure may be the only treatment needed for early laryngeal cancer.

During the procedure, the doctor inserts the endoscope through the mouth and into the larynx. He or she places small surgical instruments into the scope to remove the cancer. To spare as much of the vocal cords as possible, doctors may use a laser through the scope to remove or destroy small laryngeal tumors and precancerous tissue, called dysplasia. General anesthesia is required.

If portions of the larynx need to be removed, they can often be reconstructed to restore your ability to speak.

If laryngeal cancer cannot be easily removed with a minimally invasive procedure, surgeons may perform open surgery, which involves making an incision in the neck. General anesthesia is used.

Partial Laryngectomy

In a partial laryngectomy, surgeons remove a portion of the larynx while preserving as much of the vocal cords as possible. A partial laryngectomy may be an option in people with early cancer that has not spread.

Total Laryngectomy

For large tumors that affect most or all of the larynx, a total laryngectomy may be necessary. During this procedure, surgeons remove the entire larynx.

The larynx helps you breathe, so surgeons have to create a new pathway for air to flow in and out of the trachea, or windpipe. They connect the trachea to a small, surgically created hole in the neck called a stoma. Air flows in and out of the stoma and into the trachea. Doctors and nurses can help you adapt to using and caring for the stoma.

During or after the laryngectomy, surgeons may insert a small prosthesis connecting the trachea and esophagus, which is the muscular tube that carries food from the mouth to the stomach, to help restore your voice. Highly trained speech therapists can teach you how to talk using this prosthesis.

The esophagus is usually not affected by a total laryngectomy, so you can continue to swallow food normally.

Neck Dissection

Laryngeal cancer may spread to the lymph nodes—small organs that make and store lymphocytes, white blood cells that help fight infection—in the neck. If the results of testing show cancer in the lymph nodes, doctors may perform open surgery to remove them, in a procedure called neck dissection.

Doctors may also remove lymph nodes if they appear swollen. They send the nodes to a pathologist, who can determine whether they contain cancer.

Knowing whether the cancer has spread to the lymph nodes and surrounding tissues can help doctors determine whether radiation therapy or a combination of radiation and chemotherapy is necessary after surgery.

Recovery from surgery depends on the type of procedure performed and whether reconstructive surgery is necessary. For example, if surgeons use an endoscopic approach for an early cancer, you may be able to go home the same day. An open surgery to remove large or complex tumors may require a hospital stay of a couple of days so doctors can monitor your recovery and manage any pain and discomfort with medication. If open surgery and reconstruction are necessary, you may remain in the hospital a few days longer.

During recovery, you may meet with NYU Langone specialists for inpatient and outpatient speech and swallowing therapy. Even people who have a total laryngectomy can benefit from therapy to help restore their voices.