Cancers of the larynx, pharynx, trachea and esophagus can be managed either surgically or non-surgically (with radiation therapy with or without chemotherapy) depending on type, location, and stage of tumor. In addition to managing tumors of these areas, Dr. Anfuso and Dr. Larson also manage several other conditions as mentioned below.
Laryngectomy
Apartial laryngectomy is a surgical procedure on the voice box designed to preserve the voice. The surgeon removes part of the voice box - one vocal cord, part of a cord, or the epiglottis - and leaves the rest.
Endoscopic partial laryngectomy, in contrast to open laryngectomy, allows for maximal preservation of normal tissue, faster tolerance of an oral diet (often within one or two days of surgery), no incisions and no need for tracheotomy.
Total laryngectomy - this is a procedure that removes the entire voicebox. After the procedure, a person breathes only through a small hole in their neck and no longer breathes through their mouth and nose. Patients are able to eat normally through their mouth. The ability to speak is temporarily lost, but speech can be restored through additional surgical procedures and speech therapy.
In general, total laryngectomies are only performed for advanced cancers of the voicebox or if nonsurgical treatment has already failed to cure the cancer. We realize this is a life-changing procedure. We will thoroughly educate you on the procedure itself and what to expect after surgery. In addition, we will arrange for pre-laryngectomy education with a speech and swallow therapist prior to your surgery.
Tracheostomy
A tracheostomy is a surgical incision in the windpipe made to relieve an obstruction to breathing.
Laryngoscopy/pharyngoscopy/esophagoscopy with endoscopic excision of lesions
A laryngoscopy is an examination that allows your doctor to look at the back of your throat, your voice box and vocal cords with an instrument called a laryngoscope.
A pharyngoscopy is a procedure used to examine the back of the throat for abnormal tissue.
An esophagoscopy uses a thin, lighted tube inserted through the mouth into the esophagus to look for abnormal tissue. An endoscopic excision of lesions is the surgical removal of abnormal tissue using an endoscope.
Vocal cord injection (for vocal cord paralysis)
A vocal cord injection is a very simple procedure that can help improve voice quality in patients with vocal cord paralysis. This procedure takes only a few minutes and does not require admission to the hospital. It is performed through the mouth without the use of any incisions.
Zenkers diverticulotomy/diverticulectomy (open vs endoscopic)
Zenker’s diverticulum is an abnormality where a muscle of the upper esophagus (cricopharyngeus) becomes abnormally thickened leading to difficulty with swallowing. Over time, a pouch can form above this thickened muscle, and food can accumulate in this pouch and later be coughed up. Treatment involves cutting this thickened muscle and sometimes removing the pouch. Most of the time this can be performed endoscopically through the mouth. Rarely, an external neck incision is required.