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Having laser surgery for larynx cancer

This page tells you about having laser surgery for cancer of the voice box (larynx). You can find the following information

 

A quick guide to what’s on this page

Laser surgery for larynx cancer

Laser surgery means you can have a larynx cancer removed without having a surgical cut (incision) in your neck. The surgeon puts a tube into your mouth and down your throat as far as your voice box. This type of operation is called a transoral endoscopic resection.

You go into hospital before your surgery to meet your specialist nurse and other members of the treatment team, including a speech and language therapist. They will give you a detailed explanation of what to expect. They will also ask questions about your general health and any medicines you are taking. You may need to have tests such as blood tests, a chest X-ray and a heart trace (ECG).

For a small, early stage tumour you may have your operation as day surgery or just stay in hospital overnight. You may be able to eat and drink as soon as you are fully awake.

For larger tumours you may need to be in hospital for a few days. Your nurses will check for any bleeding or swelling of your voice box. If you have difficulty swallowing, you may have liquid food through a tube put down your nose. You will have a drip into a vein to give you fluids and medicines.

After the surgery

You may feel pain when the numbness wears off so ask for painkillers as soon as you need them. You may have painkillers into your drip at first if swallowing is painful. It is important to get up and move around as soon as possible.

Laser surgery may change your voice temporarily or long term. You may need to avoid speaking for the first few days after surgery. Your speech therapist will give you exercises to help your voice recover. Before you leave hospital your nurse will give you a follow up appointment to see your speech therapist as well as your surgeon.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating laryngeal cancer section.

 

 

Laser surgery for larynx cancer 

Laser surgery means you can have a larynx cancer removed without having a surgical cut (incision) in your neck. The surgeon puts a tube into your mouth and down your throat as far as your voice box. This type of operation is called transoral endoscopic resection.

 

Before your surgery

At least 2 weeks before your surgery, you go to a clinic to meet your doctor and nurse and have some tests. They will give you a detailed explanation of what to expect and answer any questions you have. You may hear this called a pre operative assessment clinic.

They will also ask about

  • Your general health
  • Any allergies you have
  • Any medicines you are taking

If you are taking aspirin or other blood thinning medicines regularly, they may ask you to stop taking them well before your operation. These medicines may increase the risk of bleeding.

Your nurse will organise some tests. If you had any of these tests when you first had your cancer diagnosis, you may not have to repeat them. You may have

You have these tests to make sure that you are fit enough to make a good recovery from your surgery.

Before your operation an anaesthetist will come to see you to check that you are able to have an anaesthetic. You may also have your teeth checked to see if there could be difficulty in passing the tube used for the surgery (endoscope) into your mouth. If you have had any problems eating and drinking you may also see a dietician.

You also see a speech therapist before your operation. They will check to see if you are likely to have any swallowing difficulties or changes to your voice from the operation.

 

After your operation

How long you stay in hospital will depend on the size of operation you need.

If you have a small, early stage tumour you may have your operation as day surgery or stay in hospital overnight. You may be able to eat and drink as soon as you are fully awake. Your throat will feel sore for a while when you swallow. Your nurse will give you painkillers to take home.

For larger tumours you may need to be in hospital for a few days. After your operation you may be on an ear, nose and throat (ENT) ward. Or you may be in an intensive care unit (ICU) or high dependency unit (HDU) for 1 or 2 nights.

Your nurses will check regularly for any bleeding or swelling of your voice box. Swelling can make it harder to breathe. In rare cases if swelling gets really bad, you may need to have an opening in the front of your throat. This is made just above the voice box to help you breathe. It is called a tracheostomy and is usually only temporary, until the swelling goes down.

If you have difficulty swallowing you may need to have liquid food through a tube put down your nose into your stomach (a nasogastric tube). You will have a drip into a vein to give you fluids and medicines.

 

Pain relief

You may not feel pain straight after your surgery, if you had painkillers with your anaesthetic. The laser surgery itself also numbs the nerves. You may feel pain when the numbness wears off. So it is important to ask for painkillers as soon as you need them. You may have them into your drip at first, if swallowing is painful.

 

Getting up

It is important to get up and move around as soon as possible to help your recovery. Your physiotherapist may give you leg exercises to reduce the risk of blood clots.

 

Effects on your voice

Laser surgery may affect your voice. The changes may be temporary or long term. Your surgeon may ask you to avoid speaking for the first few days after your operation.

Your speech therapist will give you exercises to help your voice recover. They can also give you advice and exercises to help you with any swallowing difficulties.

Before you leave hospital your nurse will give you a follow up appointment to see your speech therapist as well as your surgeon.

 

Possible problems during laser surgery

Very occasionally during laser surgery some people have chipped teeth, or bruised lips or gums from the breathing tube that is put into your mouth. Chipped teeth can be repaired by a dentist if needed. Any bruising of the lips or gums will go down after a few days.

Sometimes the laser may cause burns to tissues around the tumour. Your doctor will discuss these risks with you.

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Updated: 14 July 2015