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LIFE AFTER HAVING YOUR VOICE BOX REMOVED (TOTAL LARYNGECTOMY)

LIFE AFTER HAVING YOUR VOICE BOX REMOVED (TOTAL LARYNGECTOMY). Carole Glover & Hugh McGrath. Why is Total Laryngectomy performed. Laryngeal cancer involving thyroid cartilage Following recurrence / failing radiotherapy . What are the changes and functions of the anatomy . Humidification

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LIFE AFTER HAVING YOUR VOICE BOX REMOVED (TOTAL LARYNGECTOMY)

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  1. LIFE AFTER HAVING YOUR VOICE BOX REMOVED (TOTAL LARYNGECTOMY) Carole Glover & Hugh McGrath

  2. Why is Total Laryngectomyperformed • Laryngeal cancer involving thyroid cartilage • Following recurrence / failing radiotherapy

  3. What are the changes and functions of the anatomy

  4. Humidification • Speech • Swallow • Secretions • Loss of sense of smell • Altered body image

  5. Pre operative • CNS / Support Nurse and Speech Therapist pre op talk • Meet another laryngectomy patient

  6. PATENCY OF STOMA • It is essential that stoma size is maintained – ease of airway management - changing of voice prosthesis (if patient has one) • Lary Tubes (cleaned using normasol sachets + trachy cleaning swabsStoma buttons)

  7. HUMIDIFICATION • Due to altered anatomy patient’s have lost ability to filter, warm + humidify the air they breathe Methods of humidification • Heated humidification on the ward • HME cassette • Stoma protector • Normal saline nebulisers • Laryngofoam • Some pts ++mucus

  8. Surgical Voice Restoration • Use of lung air diverted through voice prosthesis into pharynx • Life span of prosthesis varies • Types of valves

  9. Self changing of prosthesis • SVR team change some prosthesis • Candida build up – leakage

  10. Post operative support • Pre discharge talk • Countrywide supplies • Emergency information – e.g. Resus • D/N twilight visit • Text number • Drop in clinic

  11. Patient experience • General fatigue • Mucus difficulties • Reduction of upper body strength following reconstructive surgery • Social problems • Day to day routine / life

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