Why is the “stoma” necessary after a laryngectomy?
by Carla Gress, SLP, UCSF Someone asked a question about laryngectomy surgeries, why they haven’t changed much in 40 years, and why you couldn’t reconstruct to avoid a stoma. Good questions! Actually things HAVE changed a lot in the last 40 years. The last 40 years has seen more aggressive attempts at using non-surgical treatments, such as radiation or combination radiation and chemotherapy to avoid surgery completely. Also, there are now partial surgeries available by which they can remove only a single vocal cord (hemilaryngectomy) or by which they remove only the epiglottis and other structures above the vocal cords (supraglottic laryngectomy). Both of these procedures are designed to avoid having a stoma, if all heals well and the patient learns how to swallow safely with the reconstructed mechanism. If we have a little anatomy/physiology tutorial, maybe it will help to understand what the surgeon faces when trying to develop a viable alternative to total laryngectomy. Essentially
