Laryngectomy is a head and neck surgical procedure that involves a permanent change to the airway.

Patients typically have presented with cancer of the larynx. Locally targeted radiotherapy or partial removal of the larynx may be possible. However, for between 600-800 patients annually in the UK, a complete surgical excision of the larynx is required to give the patient the best chance of survival.

The trachea is no longer connected to the upper airways, and now ends on the front of the neck. This is how the patient breathes, and patients can be considered as neck-only breathers. Removal of the larynx also removes the ability to vocalise as the 'voice box' is no longer there.

The anatomical and physiological changes, along with the knowledge, skills and equipment required to safely manage these patients, can have a significant impact on patients and their families.

Laryngectomy critical incidents have been reported where crucial knowledge of airway anatomy, equipment provision or appreciation of the patient's needs were lacking, leading to harm and even death in this vulnerable patient group.

This session covers the anatomical and physiological differences between tracheostomy and laryngectomy and why this is critically important. We will review common problems for laryngectomy patients, including communication, and explain basic and emergency care to keep patients safe.