Laryngectomy is surgery to remove all or part of the larynx (voice box).

Total laryngectomy removes the whole larynx. Part of your pharynx may be taken out as well. Your pharynx is the mucous membrane-lined passage between your nasal passages and esophagus.

During Laryngectomy Surgery

  • The surgeon will make a cut in your neck to open up the area. Care is taken to preserve major blood vessels and other important structures.
  • The larynx and tissue around it will be removed. The lymph nodes may also be removed.
  • The surgeon will then make an opening in your trachea and a hole in front of your neck. Your trachea will be attached to this hole. The hole is called a stoma. After surgery you will breathe through your stoma. It will never be removed.
  • Your esophagus, muscles, and skin will be closed with stitches or clips. You may have tubes coming from your wound for a while after surgery.

The surgeon may also do a tracheoesophaheal puncture (TEP). A TEP is a small hole in your windpipe (trachea) and the tube that moves food from your throat to your stomach (esophagus). Your surgeon will place a small man-made part (prosthesis) into this opening. The prosthesis will allow you to speak after your voice box has been removed.

After Laryngectomy Surgery

At Wake Forest Baptist Health, our speech-language pathologists (SLPs) provide laryngectomy pre-operative counseling, care assessment during post-operative hospital stay, and ongoing management at discharge.

During pre-operative counseling, we discuss the physiological and anatomical changes regarding speech, swallowing and respiration following a total laryngectomy, and options for communication without a voice box.

While in the hospital, an SLP will follow up with you. We offer a visit from a member of our local laryngectomy club to offer further support. We will also initiate electrolarynx training at the physician’s discretion.

Following hospitalization, our SLPs will help you find the most optimal form of communication and assist with continued stoma care and management.

Communicating After Laryngectomy

Since your vocal cords are removed during surgery, you must learn new methods for communicating and swallowing. You may also experience a change in respiration, as the airway is no longer connected to the mouth and nose, so breathing now occurs through a hole in the throat called a stoma.

Our experienced speech-language pathologists will help you every step of the way.

There are 3 common options for communication following a total laryngectomy:


Electrolarynx, also known as artificial larynx, is typically the most common form of communication immediately following surgery. It is an electronic device that acts as a separate sound source. Voicing is made either by placement against your neck or with a straw in your mouth. Your speech-language pathologist will train you in placement and use of the device.

Esophageal Speech

This is a method of speech in which you learn to swallow air into your esophagus (food tube) and release it back into the throat like a belch. The expelled air causes the muscles of the throat to vibrate to form a sound source. This method does not require any instrumentation.

Tracheoesophageal Puncture Speech

Tracheoesophageal Puncture (TEP) speech requires the creation of a tract between the breathing tube (trachea) and the food tube (esophagus) by the physician. A small prosthesis is placed in this tract to allow air to travel from the trachea to the esophagus, causing the muscles of the throat to vibrate as a sound source. A speech-language pathologist and physician will help determine if this is an appropriate method of communication.