The First Total Laryngectomy At KUTRRH
Early this year the ENT team at KUTRRH led by Dr Getachew Beza, a head and neck surgeon, performed the first total laryngectomy, which is an operation to remove the entire voice box for advanced cancers of the voice box. The patient was a 66-year-old male patient with stage four voice box cancer. The patient has since been discharged with good outcomes and continues with follow-ups as an outpatient.
The second such operation was done in April 2023 on a 70-year-old male patient with stage three cancer. Both patients presented with hoarseness of the voice and had a smoking history. They had visited different hospitals where their condition was managed as an inflammation of the throat, so they did not improve. They later separately visited KUTRRH for an ENT review which showed they had voice box cancer. They were offered the various options of treatment available and they opted for surgery as it offers the best chance of cure for advanced stages of voice box cancers.
What is Laryngeal (voice box) Cancer?
It is a type of cancer that affects the voice box. The larynx is part of the throat found at the entrance of the windpipe (trachea). It plays an important role in breathing and speech. Cancer of the voice box is commonly seen after age 55 and is four times more common in males than females.
What Causes Larynx (voice box) Cancer?
It is mainly caused by smoking and heavy alcohol consumption. Other risk factors include viral infections for instance the human papillomavirus (HPV), a family history of head and neck cancer, an unhealthy diet, and exposure to certain chemicals and substances such as asbestos and coal dust How does voice box cancer present?
How Does Voice Box Cancer Present?
Voice change is an early and commonest sign of voice box cancer. Any voice change in a smoker for over three weeks should be investigated for voice box cancer. Other presenting signs and symptoms include throat discomfort, painful swallowing, ear pain, neck swelling, and persistent cough. It may cause difficulty in breathing as the disease progresses. Some people may also experience bad breath, wheezing noise when breathing, unexplained weight loss, or fatigue (extreme tiredness)
How is Voice Box Cancer Diagnosed?
Doctors suspect voice box cancer based on clinical history and examination. Outpatient laryngoscopic examination is done to examine the throat. Examination of the throat under general anesthesia and a biopsy confirmation is mandatory for confirmation. Imaging studies like CT, MRI, PET CT, and US are also used to clearly delineate the tumor and for staging purposes.
How is Voice Box Cancer Treated?
The main treatments for laryngeal cancer are radiotherapy, surgery, and chemotherapy. Early-stage voice box cancer can be cured either with surgery or radiotherapy alone. If the cancer is advanced, a combination of surgery to remove part or the entire larynx, radiotherapy, and chemotherapy can be used. If surgery is done to remove the larynx (total laryngectomy), the patient will no longer be able to speak or breathe the usual way. Instead, the patient will breathe through a permanent hole in the neck (stoma) and will need additional treatment to help restore the voice. This may include an implant in the throat or an electrical device held against the throat to produce sound. Both patients operated on at KUTRRH were discharged and are responding positively to treatment.