A laryngectomy is defined as the surgical removal of all or part of the larynx. A laryngectomy is the individual whose larynx has been removed. Removal of the larynx can cause many problems with an individual, both physical and emotional. This study covers the areas of the history of laryngectomy, function of the larynx, causes for removal of the larynx, the surgical procedure, prosthesis selection and usage, airway protection, different speech techniques, and rehabilitation. These sections will be covered to inform readers of the different aspects involved with a laryngectomy.
History.
The first recorded laryngectomy ever done was performed on a dog, in 1829 by H. Albers. The dog survived nine days. Later in 1866, Patrick Watson preformed the first laryngectomy on a man. The patient's larynx was being devastated by syphilis; he survived the operation, but later died of pneumonia, and because of this the surgery was condemned. The first successful laryngectomy took place in 1873, by Billroth. The patient had to have a tumor removed from one of the vocal folds, but because the growth had spread the entire larynx had to be removed. He survived for one year but later died due to reoccurrence. Of the first 103 laryngectomies performed there were 39% who died from after effects of the operation ranging from several hours to 8 weeks. An additional 20% died from a reoccurrence, which resulted in death around six months. From the original 103 laryngectomies only 9 survived more than a year, and the longest survivor lasted 5 years. In order to be considered successful, a laryngectomy had to insure a survival of more than 1 year because it was believed that this length of survival could be achieved by tracheostomy alone (Henslee 1994). Acceptance of the laryngectomy came at a slow rate, primarily because of the low survival rate. Another reason was that of the physicians" opinion that the removal of one's ability to speak was seen as inhuman.